Cyclizine sublingual or rectal
| Cyclizine sublingual or rectal | |
| What is it? | Antiemetic |
| Mechanism of action | Antihistaminic antimuscarinic antiemetic |
| Starting dose | 50 mg two times to three times a day |
| Time to onset of effect | 30–60 min17 |
| Formulation | Injection given as a sublingual solution Rectal suppository (must be kept in fridge) |
| Indication | Nausea related to raised intracranial pressure Nausea-related gastrointestinal obstruction Nausea related to vestibular disorders |
| Common adverse effects | Anticholinergic adverse effects; movement disorders, potential for misuse/abuse of injections |
| Contraindications | Epilepsy; prostatic hypertrophy (in adults); pyloroduodenal obstruction; severe heart failure—may cause fall in cardiac output and associated increase in heart rate, mean arterial pressure and pulmonary wedge pressure; susceptibility to angle-closure glaucoma16 |
| Caution | Renal and hepatic impairment |
| Licence | Use of injection orally: ‘off label’ Use of suppositories: unlicensed product |
| Benefits | Alternative routes of administration |
| Risks | Delay to manufacture of suppositories |
| Cost | Oral solution: 50 mg/mL ampoules for injection—£18.58 for 5 Suppository—a special order. Price of application |