Recent Advances in Delivery Systems and Therapeutics of Cinnarizine: A Poorly Water Soluble Drug with Absorption Window in Stomach

Table 2

Clinical therapeutics and trial reports on cinnarizine.

Title	Comments	Reference
Cinnarizine for the prophylaxis of migraine associated vertigo: a retrospective study	After three months of cinnarizine therapy the mean frequency of vertigo and migraine along with the duration and intensity of migraine headaches per month were significantly reduced (). The results were suggestive for the safe and effective use of cinnarizine against co-morbidity of migraine and vertigo among patients who suffer from vestibular migraine or migraine with brain stem aura associated with vertigo.	Togha et al., [69]
Comparison of therapeutic effects of alprazolam and cinnarizine in patients with idiopathic tinnitus: a clinical trial study.	Both the drugs were effective for treatment of idiopathic tinnitus. The side effect of drowsiness was less in case of cinnarizine (31.6%) with high rate of partial remission (68.4%).	Salari et al., [70]
Efficacy and safety of cinnarizine in the prophylaxis of migraine headaches in children: an open, randomized comparative trial with propranolol	No significant difference was seen in 50% reduction of the baseline headache frequency between treatment from cinnarizine and propanolol separately () along with insignificant adverse effects. This trial proved cinnarizine to be as effective and safe as propranolol for prophylaxis of migraine in children, but recommended to be confirmed by a double-blind placebo-controlled trial.	Togha et al., [71]
A reassessment of diagnostic criteria and treatment of idiopathic urticarial vasculitis: a retrospective study of 47 patients	Most patients did not show clinical and laboratory features of urticarial vasculitis after treatment with cinnarizine. Thus set forth the use of cinnarizine as effective treatment and suggested as a valuable medication for utricarial vasculatis.	Tosoni et al., [72]
Cinnarizine in refractory migraine prophylaxis: efficacy and tolerability. A comparison with sodium valproate	Cinnarizine and sodium valproate group showed 61.2% and 63.8% subjects as responders towards treatment, respectively with no statistically significant differences, suggesting the efficacy of cinnarizine in severe migraine.	Mansoureh et al., [73]
Open-label trial of cinnarizine in migraine prophylaxis	Significant reduction in attack duration and severity () with no serious adverse events was reported, concluded the efficacy of cinnarizine as well-tolerated prophylactic antimigraine medication with early onset of effectiveness.	Togha et al., [74]
Cinnarizine has an atypical antipsychotic profile in animal models of psychosis.	The drug at a dose of 20 mg/kg significantly counter acted MK-801 (0.25 mg/kg) and amphetamine (5 mg/kg) locomotors effects and remain same on increasing dose to 60 or 180 mg/kg with appearance of mild catalepsy. The report suggested that cinnarizine has a potential antipsychotic effect.	Dall’Igna et al., [75]
Cinnarizine is a useful and well-tolerated drug in the treatment of acquired cold urticaria (ACU)	The report supported the effective and well-tolerated treatment for acquired cold utricaria by administering high dose of drug	Tosoni et al., [76]
New approaches to the management of peripheral vertigo: Efficacy and safety of two calcium antagonists in a 12-week, multinational, double-blind study	Treatment with cinnarizine reduced the incidence of moderate vertigo episodes by 65.8% and extreme vertigo by 89.8%. The report suggested efficacious use of cinnarizine for treatment of peripheral vertigo.	Pianese et al., [77]
Cinnarizine in the prophylaxis of seasickness: laboratory vestibular evaluation and sea study	Effectiveness of cinnarizine on vestibule-ocular reflex supported the potency of cinnarizine for the prevention of seasickness in lab study and during voyage in rough sea.. A dose of 50 mg was resulted in effective medication for prevention of sea sickness.	Shupak et al., [78]
The vestibulo-ocular reflex (VOR) under the influence of cinnarizine	A dose of 25 mg and 50 mg of drug, showed decrease in gained VOR. Reduction was also observed for patients treated with cinnarizine 25 mg in combination with 10 mg domperidone or 1 transdermal scopolamine patch. No notable side effects were observed, suggesting safe use of cinnarizine alone or in combination against VOR.	Doweck et al., [79]
Effect of cinnarizine on various types of vertigo. Clinical and electronystagmographic results of a double-blind study	The study provided favorable results against sudden peripheral vestibular deficit from vertigo of circulatory origin and from post traumatic vertigo. Thus concluded to be well tolerated with minor side effects for treatment against vertigo.	Hausler et al., [80]
Antihypoxidotic and nootropic drugs: Proof of their encephalographic and pharmacodynamic properties by quantitative EEG investigations	The result suggested cinnarizine induced desired EEG changes only in V-EEG showing effectiveness in case of geriatric population.	Saletu and Grunberger, [81]
Cinnarizine in the treatment of chronic asthma	The drug is also shown to exert anti-asthmatic effect in patients with chronic asthma by antagonizing calcium ion transport across the mast cell membrane. The report proved cinnarizine as first drug of a new family of anti-asthmatic drugs offering a protective effect when taken systemically.	Emanuel et al., [82]