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Vomiting is controlled by an area of the brain called the vomiting centre. The vomiting centre is responsible for causing feelings of sickness (nausea) and for the vomiting reflex. It is activated when it receives nerve messages from the vestibular apparatus in the middle ear.
The vestibular apparatus provides continual feedback to the brain about our body position. When something disturbs the vestibular apparatus, such as head movement following surgery or motion when travelling by boat or car, nerve signals are sent from the vestibular apparatus to the vomiting centre. This can cause sensations such as nausea, dizziness or spinning sensations (vertigo) and the reflex of vomiting.
Cyclizine works by blocking histamine and muscarinic receptors in the vomiting centre, which prevents the vomiting centre from receiving nerve messages from the vestibular apparatus. This prevents disturbances in the middle ear from activating the vomiting centre and causing nausea, vertigo and vomiting.
Cyclizine may also prevent the vomiting centre from receiving messages from an area of the brain called the chemoreceptor trigger zone (CTZ). The CTZ is stimulated by agents circulating in the blood, for example anaesthetics and opioid painkillers such as morphine. Cyclizine helps prevent these agents from activating the vomiting centre and causing sickness.
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