Antihistamine·Gastrointestinal - Antiemetics

Cyclizine

PONV, motion sickness, palliative care nausea, inner ear pathology

PBSANTIEMETICValoid, Nausicalm50 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

150 mg/day

Half-life

20 h

Caution: Heart Failure

CAUTION

Caution: Anticholinergic

HIGH

Cautions

Avoid / Cautions

Severe uncompensated heart failure, acute MI.

Where it stands

Rapid Summary

Overview

First-generation antihistamine with strong anticholinergic properties. Highly effective for motion sickness, vestibular nausea, and opioid-induced nausea.

Clinical Focus

Cyclizine drops cardiac output (negative inotrope). Use with extreme caution in severe heart failure.

Bottom Line

Cyclizine is a first-line antiemetic for vestibular and opioid-induced nausea, but causes sedation and anticholinergic effects and must be avoided in heart failure (reduces cardiac output).

Formulation & Access

Brand Names

Valoid, Nausicalm

Oral Routes

Tablets (50 mg).

Parenteral

Ampoules (50 mg/1 mL) for IV / IM / SC.

Prescribing & PBS

Pharmacy Medicine (S3 PO). Prescription (S4 Ampoules).

Indications & Use

Primary

PBSTGA

PONV, motion sickness, palliative care nausea, inner ear pathology.

Clinical Place

Excellent second-line agent when Ondansetron fails or causes intolerable constipation/headache.

Quick reference

Class & Role

Antihistamine — First-generation antihistamine with strong anticholinergic properties.

Route / Formulation

Tablets (50 mg). (Valoid, Nausicalm)

Usual Dose & Max

PO / IV / IM 50 mg up to TDS. Max 150 mg/day.

Key Indication Doses

Nausea / Vomiting: PO / IV / IM 50 mg up to TDS. Max 150 mg/day. Palliative Care: Continuous SC infusion via syringe driver (e.g., 100-150 mg over 24h).

Best Uses

Cyclizine is a first-line antiemetic for vestibular and opioid-induced nausea, but causes sedation and anticholinergic effects and must be avoided in heart failure (reduces cardiac output).

Key Risks

Cardiovascular: Tachycardia, hypotension, negative inotropy (decreases heart contractility). Neurological: Drowsiness, sedation, confusion (especially in the elderly). Gastrointestinal: Dry mouth, urinary retention, blurred vision (classic anticholinergic toxidrome).

Key Interactions

Additive anticholinergic effects with TCAs, antipsychotics, and Ipratropium. Additive sedation with opioids/benzos.

Monitoring

Monitor for tachycardia and signs of acute heart failure decompensation. Monitor bladder output in elderly males.

Clinical Pearl

Because cyclizine is a direct negative inotrope, giving 50 mg IV to a patient with a brittle ejection fraction can push them into acute pulmonary oedema. Use Metoclopramide or Ondansetron instead.

Access

Valoid, Nausicalm50 mg tablet

Brand: Valoid, Nausicalm
Formulation: Tablets (50 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.

Antihistamine·Gastrointestinal - Antiemetics

Cyclizine

PONV, motion sickness, palliative care nausea, inner ear pathology

PBSANTIEMETICValoid, Nausicalm50 mg tabletS4+1

No source link confirmed for this record yet. Its own source notes are under Additional.

At a glance

Max Dose

150 mg/day

Half-life

20 h

Caution: Heart Failure

CAUTION

Caution: Anticholinergic

HIGH

Cautions

Avoid / Cautions

Severe uncompensated heart failure, acute MI.

Where it stands

Rapid Summary

Overview

First-generation antihistamine with strong anticholinergic properties. Highly effective for motion sickness, vestibular nausea, and opioid-induced nausea.

Clinical Focus

Cyclizine drops cardiac output (negative inotrope). Use with extreme caution in severe heart failure.

Bottom Line

Cyclizine is a first-line antiemetic for vestibular and opioid-induced nausea, but causes sedation and anticholinergic effects and must be avoided in heart failure (reduces cardiac output).

Formulation & Access

Brand Names

Valoid, Nausicalm

Oral Routes

Tablets (50 mg).

Parenteral

Ampoules (50 mg/1 mL) for IV / IM / SC.

Prescribing & PBS

Pharmacy Medicine (S3 PO). Prescription (S4 Ampoules).

Indications & Use

Primary

PBSTGA

PONV, motion sickness, palliative care nausea, inner ear pathology.

Clinical Place

Excellent second-line agent when Ondansetron fails or causes intolerable constipation/headache.

Quick reference

Class & Role

Antihistamine — First-generation antihistamine with strong anticholinergic properties.

Route / Formulation

Tablets (50 mg). (Valoid, Nausicalm)

Usual Dose & Max

PO / IV / IM 50 mg up to TDS. Max 150 mg/day.

Key Indication Doses

Nausea / Vomiting: PO / IV / IM 50 mg up to TDS. Max 150 mg/day. Palliative Care: Continuous SC infusion via syringe driver (e.g., 100-150 mg over 24h).

Best Uses

Cyclizine is a first-line antiemetic for vestibular and opioid-induced nausea, but causes sedation and anticholinergic effects and must be avoided in heart failure (reduces cardiac output).

Key Risks

Key Interactions

Additive anticholinergic effects with TCAs, antipsychotics, and Ipratropium. Additive sedation with opioids/benzos.

Monitoring

Monitor for tachycardia and signs of acute heart failure decompensation. Monitor bladder output in elderly males.

Clinical Pearl

Because cyclizine is a direct negative inotrope, giving 50 mg IV to a patient with a brittle ejection fraction can push them into acute pulmonary oedema. Use Metoclopramide or Ondansetron instead.

Access

Valoid, Nausicalm50 mg tablet

Brand: Valoid, Nausicalm
Formulation: Tablets (50 mg).

From this page

No calculator, monitoring schedule or factsheet is linked to this medicine page yet.