Cinnarizine, dimenhydrinate (Arlevert)

How does it work?

Arlevert tablets contain two active ingredients, cinnarizine and dimenhydrinate, both of which are antihistamine medicines. Arlevert tablets are used to treat symptoms of various types of vertigo.

Vertigo is described as a spinning or swaying sensation whilst standing still. It is commonly caused by a problem with the vestibular apparatus in the middle ear. The vestibular apparatus provides continual feedback to the brain about our body position. When something disturbs it, nerve signals are sent from the vestibular apparatus to the vomiting centre in the brain. This can cause sensations such as nausea, dizziness or spinning sensations (vertigo) and the reflex of vomiting.

This medicine works by blocking histamine and muscarinic receptors in the vomiting centre in the brain. This prevents the vomiting centre from receiving the nerve messages from the vestibular apparatus in the middle ear. In turn, this prevents disturbances in the middle ear from activating the vomiting centre and causing vertigo, nausea and vomiting.

Arlevert tablets are usually taken for a maximum of four weeks.

What is it used for?

  • Relieving symptoms of vertigo, such as nausea, vomiting, attacks of dizziness or spinning sensations.


  • This medicine may cause drowsiness. If affected do not drive or operate machinery. Alcohol should be avoided.
  • This medicine can upset your stomach: taking it with or after food may help to reduce the indigestion.
  • If you are due to have any skin prick tests to diagnose allergies you should stop taking this medicine at least 48 hours before the tests. This is because antihistamines can prevent or lessen the skin reactions that indicate an allergy, and so can make the test results unreliable.

Use with caution in

  • People with mild to moderately decreased kidney function.
  • People with mild to moderately decreased liver function.
  • Parkinson's disease.
  • Enlarged prostate gland (prostatic hypertrophy).
  • People with a blockage of the area where the stomach joins the intestines (pyloroduodenal obstruction).
  • People with high or low blood pressure.
  • Severe disease involving the heart and blood vessels (cardiovascular disease).
  • Overactive thyroid gland (hyperthyroidism).
  • People with raised pressure in the eye, eg open angle glaucoma.
  • Rare hereditary blood disorders called porphyrias.

Not to be used in

  • People with severely decreased kidney function.
  • People with severely decreased liver function.
  • Closed angle glaucoma.
  • People with increased pressure in the brain (raised intracranial pressure).
  • People who are intoxicated with alcohol (acute alcoholism).
  • Convulsions, eg epilepsy.
  • People with difficulty passing urine (urinary retention), due to prostate problems.
  • Pregnancy.
  • Breastfeeding.
  • This medicine is not recommended for children and adolescents under 18 years of age, as there is no information regarding its safety and efficacy in this age group.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.

If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

  • The safety of this medicine for use during pregnancy has not been established. It should not be used by pregnant women. Seek medical advice from your doctor.
  • This medicine may pass into breast milk and could have unwanted effects on a nursing infant. For this reason it should not be used by women who are breastfeeding. Seek medical advice from your doctor.

Label warnings

  • This medication may cause drowsiness. If affected do not drive or operate machinery. Avoid alcoholic drink.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here, it does not mean that all people using this medicine will experience that or any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

  • Drowsiness.
  • Headache.
  • Dry mouth.
  • Abdominal pain.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

  • Loss of memory (amnesia).
  • Sensation of ringing, or other noise in the ears (tinnitus).
  • Tremor.
  • Convulsions.
  • Nervousness.
  • Disturbances of the gut, such as nausea, diarrhoea, and indigestion.
  • Sweating.
  • Rash.
  • Pins and needles sensations (paraesthesia).

Rare (affect between 1 in 1000 and 1 in 10,000 people)

  • Increased sensitivity of the skin to UV light (photosensitivity).
  • Difficulty in urinating.
  • Vision disturbances.
  • Allergic reactions.

Very rare (affect less than 1 in 10,000 people)

  • Decrease in the number of white blood cells in the blood (leucopenia).
  • Decrease in the number of platelets in the blood (thrombocytopenia).
  • Partial or total failure of blood cell development (aplastic anaemia).

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer. For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you start treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines while taking this one, to ensure that the combination is safe.

There will be increased drowsiness and sedation if this medicine is taken in combination with any of the following (which can also cause drowsiness):

  • alcohol
  • antipsychotics, eg haloperidol
  • barbiturates, eg phenobarbital, amobarbital
  • benzodiazepines, eg diazepam, temazepam
  • MAOI antidepressants, eg phenelzine, isocarboxazid or tranylcypromine
  • other sedating antihistamines, eg chlorphenamine, hydroxyzine
  • sleeping tablets, eg zopiclone
  • strong opioid painkillers, eg codeine, dihydrocodeine, morphine
  • tricyclic antidepressants, eg amitriptyline.

There may be an increased risk of side effects such as dry mouth, blurred vision, urine retention and constipation if this medicine is taken with anticholinergic medicines that can cause this type of side effect, such as the following:

  • anticholinergic medicines for Parkinson's symptoms, eg procyclidine, orphenadrine, trihexyphenidyl
  • anticholinergic medicines for urinary incontinence, eg tolterodine, oxybutynin
  • antipsychotics, eg chlorpromazine, clozapine
  • antispasmodics, eg hyoscine, atropine
  • MAOI antidepressants, eg phenelzine, isocarboxazid or tranylcypromine
  • tricyclic antidepressants, eg amitriptyline, imipramine.

Other medicines containing the same active ingredients

There are currently no other medicines available in the UK that contain both cinnarizine and dimenhydrinate as the active ingredients.

Stugeron contains just cinnarizine.