Misc Safety of cyclizine

[Spurs_1882]

I suffer from severe IBS and associated malnutrition.

One of my worst symptoms is nausea. It's stopping me from eating and I could end up in hospital and/or on a nasogastric tube due to weight loss. Got prescribed cyclizine 50mg which seemed to do very little, particularly after I'd used it more often and gained a tolerance. Yesterday, out of desperation, I tried 100mg and my nausea went away entirely! This meant I could eat

I was wondering if anyone knew if it was dangerous in either the short or long term to take 100mg rather than 50mg? I'd probably only be using it now and then, not every day. Bit of a weird question to ask here perhaps but I couldn't find any information elsewhere on the net. The maximum dose for prescription/in hospitals appears to be 50mg, which is why I was slightly concerned, but I know that some drug users take higher doses.

Edit: that is to say, I tried 100mg all in one go, not spread out. I am allowed 150mg spread out over the day, but this doesn't really touch my nausea.

 

[BehindtheShadow]

I use librax for my ibs it works like a charm

 

[Spurs_1882]

Dimenhydrinate is also good for nausea, did you try dimenhydrinate/diphenhydramine before?

No I haven't done. What would be the dosage? It appears to be OTC here in the UK. Can it be combined with cyclizine or is that dodgy? I might get some. Thanks.

 

[Spurs_1882]

I use librax for my ibs it works like a charm

Thanks for the reply. It's not available here in the UK, but I have benzos which do help the IBS. Not sure if I can get the clidinium bromide (the other active ingredient) from anywhere in order to replicate the librax.

 

[kleinerkiffer]

The maximum daily dosage is 150 mg from what I've read, so you should be fine.
Now taking an antihistamine (which also works as an anticholinergic) longterm comes with certain risks:
"Higher cumulative anticholinergic use is associated with an increased risk for dementia" https://www.ncbi.nlm.nih.gov/pubmed/25621434 but imo if it helps with your nausea and increases your quality of life it's a risk I'd take without a blink (I suffer from IBS as well)

 

[Spurs_1882]

The maximum daily dosage is 150 mg from what I've read, so you should be fine.
Now taking an antihistamine (which also works as an anticholinergic) longterm comes with certain risks:
"Higher cumulative anticholinergic use is associated with an increased risk for dementia" https://www.ncbi.nlm.nih.gov/pubmed/25621434 but imo if it helps with your nausea and increases your quality of life it's a risk I'd take without a blink (I suffer from IBS as well)

Thank you. I think I remember you from me asking IBS-related questions before. I'm okay with staying under 150mg per day, but I think that presumes you taking only 50mg in each individual dose.

I just wonder if 100mg is too much all in one go. From googling it, it appears to be licenced for 100mg in Zambia and South Africa but not in most countries. I'll probably go with it as it seems to be fine, but I feel a bit anxious about it. Cyclizine has been known to cause movement disorders I think, though not as much as some other anti-emetics such as metoclopramide, which also helps me.

What have you found to be helpful for your IBS? Ultimately I don't think meds are the answer to IBS but I just need something when symptoms get really bad so that I can still eat. I don't want to end up on a nasogastric tube.

 

[kleinerkiffer]

Well, I'm not a doctor so take everything with a grain of salt.
Afaik cyclicine acts as a H1-receptor antagonist and as an anticholinergic (acetylcholine is a really important neurotransmitter, especially in muscle function). If you take a higher dose side effects will increase, those include stuff like drowsiness (probably due to H-receptor antagonism) and nastier stuff like tachycardia (acetylcholine decreases heart rate so by inhibiting it your heart rate will increase), constipation (can be seen as a pro if you have IBS-D), confusion/hallucinations (most likely due to anticholinergic action as well, but usually this only occures in extremely high doses) and extrapyramidal effects(=movement disorder as acetylcholine is important in the corpus striatum iirc).
I don't know if taking 100 mg instead of 50 mg will increase those side effects significantely and a quick search for papers didn't help, but I think you shouldn't worry too much. Imo if 100 mg helps you should stick with it, but if you experience any (serious) side effects drop down to 50 mg or switch to another med.

Well, I tried quite a lot but most don't work/come with nasty side effects. For me (IBS-D) the only things i take are buscopan (Hyoscine butylbromide) and if I have really bad symptoms codeine helps too, but for me it comes with many side effects.
Imo IBS has something to do with the microbiome and the gut-brain axis and in the future I'll try rifaximine (antibiotic) and there's the option of a stool transplant. Psychotherapy helps (for me I realized that my emotions are coupled to my gut motility, i.e. if I'm anxious for example I'll have more problems than usual), but it's a long term comitment (for me it's 300 hours of analytical psychotherapy). There are other things like diet (I don't tolerate fructose for example) and maybe a problem with the gallbladder/pancreas. I could go on but I don't want to go too much off topic, but you can always PM me

 

[kleinerkiffer]

Can't edit right now so have to double post:
Diphenhydramine belongs to the same class of drugs as cyclizine (antihistamine with anticholinergic effects) so they work in similar ways. Combining them will increase side effects and can be dangerous.
I have some experience with dph and ime it's really sedating so start with a low dose if you try it

Librax is the combination of chlordiazepoxide (benzodiazepine) and clidinium bromide, afaik clidinium bromide (muscarinic acetylchline receptor antagonist) isn't available in europe, but you could recreate it with any benzo and buscopan, this combo should give similar effects

 

[Spurs_1882]

Well, I'm not a doctor so take everything with a grain of salt.
Afaik cyclicine acts as a H1-receptor antagonist and as an anticholinergic (acetylcholine is a really important neurotransmitter, especially in muscle function). If you take a higher dose side effects will increase, those include stuff like drowsiness (probably due to H-receptor antagonism) and nastier stuff like tachycardia (acetylcholine decreases heart rate so by inhibiting it your heart rate will increase), constipation (can be seen as a pro if you have IBS-D), confusion/hallucinations (most likely due to anticholinergic action as well, but usually this only occures in extremely high doses) and extrapyramidal effects(=movement disorder as acetylcholine is important in the corpus striatum iirc).
I don't know if taking 100 mg instead of 50 mg will increase those side effects significantely and a quick search for papers didn't help, but I think you shouldn't worry too much. Imo if 100 mg helps you should stick with it, but if you experience any (serious) side effects drop down to 50 mg or switch to another med.

Well, I tried quite a lot but most don't work/come with nasty side effects. For me (IBS-D) the only things i take are buscopan (Hyoscine butylbromide) and if I have really bad symptoms codeine helps too, but for me it comes with many side effects.
Imo IBS has something to do with the microbiome and the gut-brain axis and in the future I'll try rifaximine (antibiotic) and there's the option of a stool transplant. Psychotherapy helps (for me I realized that my emotions are coupled to my gut motility, i.e. if I'm anxious for example I'll have more problems than usual), but it's a long term comitment (for me it's 300 hours of analytical psychotherapy). There are other things like diet (I don't tolerate fructose for example) and maybe a problem with the gallbladder/pancreas. I could go on but I don't want to go too much off topic, but you can always PM me

Thank you. I will send you a PM.