Cyclizine

In recent years, cyclizine has become more popular for the prevention and treatment of PONV. Although there are relatively few well controlled studies, its popularity probably reflects reasonable efficacy combined with a low incidence of side-effects. Its elimination half-life is 13-20 h.

Extrapyramidal side-effects are not associated with cyclizine, but sedation and dry mouth (anticholinergic action) may occur. Other complications include urinary retention, blurred vision, restlessness and hallucinations when given in large doses. In patients with severe cardiac failure, it may increase arterial pressure, heart rate and pulmonary wedge pressure, leading to a reduction in cardiac output.

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