What are the most effective tablets for vertigo. How does meclizine work to alleviate vertigo symptoms. Are there any side effects or precautions to consider when using vertigo medications. Which other treatments can be combined with medication for optimal vertigo relief.

Understanding Vertigo and Its Impact on Daily Life

Vertigo is a disorienting condition characterized by a sensation of spinning or dizziness, often accompanied by nausea and balance problems. This condition can significantly impact a person’s quality of life, making simple tasks challenging and potentially dangerous. But what causes vertigo, and how can it be effectively treated?

Vertigo can stem from various underlying issues, including inner ear problems, vestibular neuritis, or Meniere’s disease. Identifying the root cause is crucial for determining the most appropriate treatment approach. While several medications are available to manage vertigo symptoms, meclizine has gained recognition as one of the most effective options.

Meclizine: A Potent Antihistamine for Vertigo Relief

Meclizine, marketed under brand names such as Dramamine II and Antivert, is an antihistamine medication widely prescribed for vertigo and motion sickness. But how does meclizine work to alleviate these symptoms?

Meclizine functions by blocking signals to the brain that cause nausea, vomiting, and dizziness. By interrupting these signals, it helps reduce the intensity of vertigo symptoms and provides relief to patients. This mechanism of action makes meclizine particularly effective for vertigo caused by inner ear problems.

Dosage and Administration of Meclizine

The appropriate dosage of meclizine can vary depending on the severity of symptoms and individual patient factors. Typically, adults may be prescribed 25-100 mg of meclizine per day, divided into multiple doses. However, it’s crucial to follow the specific instructions provided by your healthcare provider.

• For motion sickness: 25-50 mg taken 1 hour before travel
• For vertigo: 25-100 mg daily, divided into 1-4 doses

Can meclizine be taken long-term for chronic vertigo? While meclizine can be effective for short-term relief, long-term use should be monitored by a healthcare professional due to potential side effects and the risk of masking underlying conditions.

Potential Side Effects and Precautions of Meclizine

While meclizine is generally well-tolerated, it’s essential to be aware of potential side effects and take necessary precautions. Common side effects may include:

• Drowsiness
• Dry mouth
• Blurred vision
• Constipation

More severe side effects, though rare, can include confusion, difficulty urinating, or allergic reactions. It’s crucial to inform your healthcare provider of any unusual symptoms or reactions while taking meclizine.

Are there any contraindications for meclizine use? Meclizine should be used with caution in patients with certain conditions, including:

• Glaucoma
• Enlarged prostate
• Liver or kidney disease
• Asthma

Additionally, meclizine may interact with other medications, particularly those affecting the central nervous system. Always inform your doctor about all medications and supplements you’re taking to avoid potential interactions.

Alternative Medications for Vertigo Treatment

While meclizine is a popular choice, other medications can also be effective in treating vertigo. These alternatives may be considered based on the underlying cause of vertigo or if meclizine proves ineffective or unsuitable for a patient.

Betahistine

Betahistine is commonly prescribed for Meniere’s disease-related vertigo. It works by improving blood flow in the inner ear, potentially reducing the frequency and severity of vertigo episodes.

Dimenhydrinate

Similar to meclizine, dimenhydrinate is an antihistamine that can help alleviate vertigo symptoms, particularly those associated with motion sickness.

Promethazine

Promethazine is another antihistamine that can be effective in managing vertigo and associated nausea. It’s often used when other medications haven’t provided sufficient relief.

How do these alternative medications compare to meclizine in terms of efficacy? While individual responses can vary, studies have shown that meclizine generally provides comparable or superior relief for most vertigo cases compared to these alternatives. However, the choice of medication often depends on the specific cause of vertigo and individual patient factors.

Combining Medications with Non-Pharmacological Treatments

While medications can provide significant relief from vertigo symptoms, combining them with non-pharmacological treatments often yields the best results. These complementary approaches can help address the underlying causes of vertigo and improve overall balance and well-being.

Vestibular Rehabilitation Therapy

Vestibular rehabilitation therapy (VRT) is a specialized form of physical therapy designed to retrain the brain to process balance information more effectively. This therapy can be particularly beneficial for patients with chronic vertigo or those recovering from vestibular disorders.

What does vestibular rehabilitation therapy involve? VRT typically includes a variety of exercises aimed at:

• Improving gaze stability
• Enhancing balance and coordination
• Reducing sensitivity to motion
• Strengthening muscles involved in maintaining balance

When combined with appropriate medication, VRT can significantly improve outcomes for vertigo patients, often leading to faster recovery and better long-term management of symptoms.

Dietary Modifications

For some vertigo patients, particularly those with Meniere’s disease, dietary modifications can play a crucial role in managing symptoms. These modifications often focus on reducing sodium intake and avoiding trigger foods.

Which dietary changes can help alleviate vertigo symptoms?

• Limiting salt intake to less than 2,000 mg per day
• Reducing caffeine and alcohol consumption
• Avoiding processed foods high in sodium
• Staying well-hydrated

While these dietary changes may not replace medication, they can complement pharmacological treatments and potentially reduce the frequency and severity of vertigo episodes.

The Role of Stress Management in Vertigo Treatment

Stress and anxiety can exacerbate vertigo symptoms and even trigger episodes in some individuals. Therefore, incorporating stress management techniques into a comprehensive vertigo treatment plan can be highly beneficial.

Mindfulness and Relaxation Techniques

Practicing mindfulness and relaxation techniques can help reduce stress levels and potentially minimize vertigo episodes. These techniques may include:

• Deep breathing exercises
• Progressive muscle relaxation
• Guided imagery
• Meditation

How can these techniques complement medication in vertigo treatment? By reducing overall stress and anxiety levels, these practices may help decrease the frequency of vertigo episodes and improve patients’ ability to cope with symptoms when they do occur.

Cognitive Behavioral Therapy

For some vertigo patients, particularly those with a strong psychological component to their symptoms, cognitive behavioral therapy (CBT) can be a valuable addition to their treatment regimen. CBT can help patients develop coping strategies, manage anxiety related to vertigo, and improve overall quality of life.

Can CBT reduce the need for medication in vertigo treatment? While CBT is not a replacement for medication, it can potentially reduce reliance on pharmacological interventions by helping patients better manage their symptoms and associated anxiety.

Emerging Treatments and Future Directions in Vertigo Management

As research in the field of vestibular disorders continues to advance, new treatments and approaches for managing vertigo are emerging. These innovative therapies offer hope for patients who may not respond well to traditional treatments or seek alternatives to long-term medication use.

Vestibular Implants

Vestibular implants, similar in concept to cochlear implants, are being developed to help restore balance function in patients with severe vestibular loss. These devices aim to replace the function of the damaged vestibular system by providing electrical stimulation to the vestibular nerve.

How do vestibular implants work? These devices typically consist of motion sensors that detect head movements and translate them into electrical signals, which are then transmitted to the vestibular nerve. This artificial stimulation helps the brain maintain balance and spatial orientation.

While still in the experimental stage, early results from clinical trials have shown promising outcomes for patients with bilateral vestibular loss. As this technology continues to develop, it may offer a groundbreaking solution for patients with severe, medication-resistant vertigo.

Gene Therapy

Gene therapy is another area of active research in the treatment of vestibular disorders. This approach aims to correct genetic defects that may contribute to certain types of vertigo or balance disorders.

What potential does gene therapy hold for vertigo treatment? Gene therapy could potentially offer a more targeted and long-lasting solution for certain types of vertigo, particularly those with a clear genetic component. By addressing the root cause at a genetic level, this approach may provide more comprehensive and sustained relief compared to symptom-focused treatments.

While still in early stages of research, gene therapy represents an exciting frontier in vertigo treatment that could revolutionize management approaches in the future.

Personalized Medicine Approaches to Vertigo Treatment

As our understanding of vertigo and its underlying causes continues to grow, there’s an increasing focus on personalized medicine approaches to treatment. This individualized strategy aims to tailor treatment plans based on a patient’s specific type of vertigo, genetic makeup, and other individual factors.

Pharmacogenomics in Vertigo Treatment

Pharmacogenomics, the study of how an individual’s genetic makeup influences their response to drugs, is becoming increasingly relevant in vertigo treatment. This field holds the potential to help healthcare providers select the most effective medications with the least side effects for each patient based on their genetic profile.

How can pharmacogenomics improve vertigo treatment outcomes? By analyzing a patient’s genetic markers, doctors may be able to predict:

• Which medications are likely to be most effective for that individual
• Optimal dosage levels
• Potential side effects or adverse reactions

This personalized approach could significantly improve treatment efficacy and patient safety, potentially reducing the trial-and-error process often associated with finding the right medication and dosage.

Precision Diagnostics

Advancements in diagnostic technologies are also paving the way for more precise and personalized vertigo treatment. These include:

• Advanced imaging techniques for detailed visualization of inner ear structures
• Vestibular function tests that can pinpoint specific areas of dysfunction
• Genetic testing to identify hereditary factors contributing to vertigo

By providing a more comprehensive and detailed picture of each patient’s condition, these diagnostic tools enable healthcare providers to develop highly targeted treatment plans that address the specific underlying causes of vertigo in each individual.

How do precision diagnostics contribute to better vertigo management? By identifying the exact nature and location of vestibular dysfunction, these tools allow for more targeted interventions, potentially leading to faster symptom relief and better long-term outcomes.

The Importance of Patient Education and Self-Management in Vertigo Treatment

While medications and medical interventions play a crucial role in vertigo treatment, patient education and self-management strategies are equally important for optimal outcomes. Empowering patients with knowledge and tools to manage their condition can significantly improve quality of life and reduce the impact of vertigo on daily activities.

Understanding Triggers and Warning Signs

Educating patients about potential triggers for vertigo episodes and early warning signs can help them take proactive measures to prevent or minimize attacks. Common triggers may include:

• Certain head movements or positions
• Stress or anxiety
• Dietary factors (e.g., high salt intake, caffeine, alcohol)
• Changes in atmospheric pressure
• Lack of sleep or fatigue

By recognizing these triggers and early symptoms, patients can take appropriate action, such as modifying their environment, practicing stress-reduction techniques, or taking prescribed medication at the onset of symptoms.

Home-Based Exercises and Techniques

Many patients can benefit from learning and regularly practicing home-based exercises designed to improve balance and reduce vertigo symptoms. These may include:

• Gaze stabilization exercises
• Balance training activities
• Modified Epley maneuver for benign paroxysmal positional vertigo (BPPV)
• Brandt-Daroff exercises

How can patients ensure they’re performing these exercises correctly? It’s crucial for healthcare providers to thoroughly demonstrate these techniques and provide clear, written instructions. Regular follow-up appointments can help ensure patients are performing the exercises correctly and making progress.

Lifestyle Modifications

In addition to medication and exercises, certain lifestyle modifications can significantly impact vertigo management. These may include:

• Maintaining a consistent sleep schedule
• Regular physical activity to improve overall balance and coordination
• Avoiding sudden movements or changes in position
• Using assistive devices when necessary to prevent falls
• Keeping a vertigo diary to track symptoms, triggers, and effective management strategies

By incorporating these self-management strategies into their daily routine, patients can take an active role in managing their vertigo, potentially reducing their reliance on medication and improving overall quality of life.

What role do support groups play in vertigo management? Joining support groups or online communities can provide valuable emotional support and practical tips for living with vertigo. These groups offer a platform for patients to share experiences, coping strategies, and stay informed about the latest treatments and research.

Dramamine II Advanced Patient Information

Generic name: meclizine [ MEK-li-zeen ]
Drug class: Anticholinergic antiemetics

Medically reviewed by Drugs.com. Last updated on Aug 21, 2022.

Uses for Dramamine II

Meclizine is used to prevent and control nausea, vomiting, and dizziness caused by motion sickness. It is also used for vertigo (dizziness or lightheadedness) caused by ear problems.

Meclizine is an antihistamine. It works to block the signals to the brain that cause nausea, vomiting, and dizziness.

This medicine is available only with your doctor’s prescription.

Before using Dramamine II

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies have not been performed on the relationship of age to the effects of Antivert® tablets and chewable tablets in children or Antivert®/25 or Antivert®/50 tablets in children younger than 12 years of age. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of meclizine in the elderly. However, elderly patients are more likely to have age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving meclizine.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Potassium Citrate
• Tranylcypromine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfentanil
• Alprazolam
• Amantadine
• Amifampridine
• Amobarbital
• Anileridine
• Benzhydrocodone
• Bromazepam
• Buprenorphine
• Bupropion
• Buspirone
• Butabarbital
• Butorphanol
• Calcium Oxybate
• Cannabidiol
• Cannabis
• Cetirizine
• Chloral Hydrate
• Chlordiazepoxide
• Chlorpromazine
• Clobazam
• Clonazepam
• Clorazepate
• Clozapine
• Codeine
• Daridorexant
• Dexmedetomidine
• Diazepam
• Difenoxin
• Dihydrocodeine
• Diphenhydramine
• Diphenoxylate
• Donepezil
• Doxylamine
• Esketamine
• Estazolam
• Eszopiclone
• Ethchlorvynol
• Ethylmorphine
• Fentanyl
• Flibanserin
• Flurazepam
• Fospropofol
• Gabapentin
• Gabapentin Enacarbil
• Glucagon
• Glycopyrrolate
• Glycopyrronium Tosylate
• Halazepam
• Hydrocodone
• Hydromorphone
• Hydroxyzine
• Ketamine
• Ketazolam
• Ketobemidone
• Lemborexant
• Levocetirizine
• Levorphanol
• Lofexidine
• Lorazepam
• Loxapine
• Magnesium Oxybate
• Meperidine
• Meprobamate
• Methacholine
• Methadone
• Methotrimeprazine
• Metoclopramide
• Midazolam
• Morphine
• Morphine Sulfate Liposome
• Nalbuphine
• Nicomorphine
• Nitrazepam
• Opium
• Opium Alkaloids
• Oxazepam
• Oxycodone
• Oxymorphone
• Papaveretum
• Paregoric
• Pentazocine
• Pentobarbital
• Periciazine
• Phenobarbital
• Piritramide
• Pitolisant
• Potassium Oxybate
• Prazepam
• Pregabalin
• Promethazine
• Propofol
• Propoxyphene
• Quazepam
• Quetiapine
• Ramelteon
• Remimazolam
• Revefenacin
• Ropeginterferon Alfa-2b-njft
• Scopolamine
• Secobarbital
• Secretin Human
• Sodium Oxybate
• Sufentanil
• Tapentadol
• Temazepam
• Thioridazine
• Tilidine
• Tiotropium
• Tramadol
• Trazodone
• Triazolam
• Zaleplon
• Zolpidem
• Zopiclone

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Asthma or
• Enlarged prostate or
• Glaucoma—Use with caution. May make these conditions worse.

• Kidney disease or
• Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper use of Dramamine II

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

Chew or crush the chewable tablet completely before swallowing. Do not swallow it whole.

Swallow the non-chewable tablet whole. Do not crush, chew, or break it.

Dosing

The dose of this medicine will be different for different patients. Follow your doctor’s orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

• For oral dosage form (tablets):
  • For nausea, vomiting, and dizziness caused by motion sickness:
    • Adults—At first, 25 to 50 milligrams (mg) taken 1 hour before travel. You may take another dose once every 24 hours while traveling.
    • Children 12 years of age and older—Use and dose must be determined by your doctor.
    • Children younger than 12 years of age—Use is not recommended.
  • For vertigo:
    • Adults—25 to 100 milligrams (mg) per day, taken in divided doses.
    • Children—Use and dose must be determined by your doctor.

Missed Dose

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions while using Dramamine II

It is very important that your doctor check your or your child’s progress at regular visits to make sure that this medicine is working properly and to check for unwanted effects.

This medicine may cause some people to become drowsy or less alert than they are normally. Do not drive or do anything else that could be dangerous until you know how this medicine affects you.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds, sedatives, tranquilizers, antidepressants, or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your medical doctor or dentist before taking any of the above while you or your child are using this medicine.

Side Effects of Dramamine II

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known

• Cough
• difficulty swallowing
• dizziness
• drowsiness
• fast heartbeat
• hives, itching, skin rash
• puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
• tightness in the chest
• unusual tiredness or weakness
• vomiting

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Rare

• Blurred vision

Incidence not known

• Dry mouth
• headache

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

More about Dramamine II (meclizine)

• Check interactions
• Compare alternatives
• Reviews (7)
• Side effects
• Dosage information
• During pregnancy
• Drug class: anticholinergic antiemetics
• Breastfeeding

Patient resources

Other brands

Antivert, Bonine, Meclicot, Meni-D, … +2 more

Professional resources

• Prescribing Information

Other formulations

• Dramamine
• Dramamine Less Drowsy

Related treatment guides

• Nausea/Vomiting
• Motion Sickness
• Vertigo

Further information

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Ménière’s Disease | Symptoms and Treatment

What is Ménière’s disease?

Ménière’s disease is a condition of the inner ear. About 1 in a 1,000 people develop Ménière’s disease. It can affect anyone at any age but it most commonly begins between the ages of 40 and 60. Generally, this condition starts in one ear only. The other ear is also affected at some stage in about 4 in 10 cases.

Ménière’s disease is named after a French doctor called Prosper Ménière who first described the disease in the 1860s.

Ménière’s diseases symptoms

Symptoms that come and go

Ménière’s disease typically comes in attacks (episodes) of the following symptoms:

• Dulled hearing in the affected ear(s). The degree of hearing loss varies.
• Vertigo. This is dizziness with a spinning sensation. It can be quite severe and make you feel sick or be sick (vomit). Vertigo can develop with little or no warning. You may feel very dizzy and ill. You may need to go to bed until it passes.
• Tinnitus. This is a noise such as a ringing, roaring or buzzing which you can hear from inside the affected ear.
• Ear pressure. You may have a sense of fullness or pressure inside the ear.
• Loud noises may seem unpleasant and distorted.

An attack of Ménière’s disease may last from 20 minutes to several hours. The average is 2-4 hours. Many people feel quite sleepy after an attack. Slight unsteadiness may last a day or so after an attack – sometimes longer.

The symptoms can vary from person to person and from time to time in the same person. A typical attack is of vertigo, hearing loss and tinnitus, which lasts a few hours. However, some people only have the vertigo without the hearing loss. Attacks of hearing loss without vertigo are uncommon. Some people just have slight vertigo during an attack. Others are severely affected and vomit for several hours.

Attacks may be frequent, or occur only every few months or longer. Sometimes they come in clusters of several attacks in quick succession. For example, attacks may occur every couple of days for a week or so. Some attacks may be so close together that it may seem that one attack lasts for several days. On average, there may be 6-11 clusters a year.

At the start, symptoms may occur on one side only but as the years go by some people have symptoms on both sides.

An uncommon symptom is to have sudden unexplained falls (drop attacks). These are falls without losing consciousness. Drop attacks last just a short time with little associated vertigo. They occur in about 1 in 25 people with Ménière’s disease. So, although uncommon, drop attacks can be alarming and potentially dangerous if, for example, the person is climbing up a ladder or driving when one occurs.

There may be long periods of time (months or years) between attacks (or clusters of attacks) when there are no symptoms. In about 7 in 10 people with Ménière’s disease, the attacks stop altogether within 5-10 years of starting.

Symptoms that may become permanent

If permanent symptoms develop, they usually take months or years to develop.

• Hearing loss. During each attack the hearing loss is temporary at first. In the early stages of the disease the hearing usually reverts back to normal when an attack is over. In time, some permanent hearing loss may develop. In some people this becomes worse and leads to deafness in the affected ear. In people who have Ménière’s disease for several years, the vertigo attacks may become fewer; however, the deafness may become the most serious symptom. In particular, if both ears are affected.
• Tinnitus. Like hearing loss, tinnitus is often temporary at first during each attack. Again, like hearing loss, it eventually becomes permanent in some cases.

Some people report fatigue and a sense of imbalance following an attack of vertigo, which can last some time. Some people have reported that these symptoms have become permanent. However, whether these symptoms are an actual feature of Ménière’s disease is debatable.

What causes Ménière’s disease?

It is thought to be caused by slight changes and damage within the inner ear.

Inner ear diagram

Cross-section of the ear

The inner ear includes the cochlea and semicircular canals. These are small shell-like structures in which there is a system of narrow fluid-filled channels called the labyrinth. The semicircular canals sense movement of the head and help to control balance and posture. The cochlea is concerned with hearing. Messages of balance and sound are sent down nerves (the vestibular nerve and the cochlear nerve) to the brain.

Signs of tinnitus to look out for in children

Think of tinnitus and it’s likely you’ll associate the hearing condition with the older generati…

It is thought that a build-up of fluid in the labyrinth from time to time causes the symptoms. The build-up of fluid may increase the pressure and cause swelling of the labyrinth. Also, fluid may leak between different parts of the labyrinth. These effects may cause the inner ear to send abnormal messages to the brain, which causes the dizziness and being sick (vomiting).

An increased pressure of fluid on the hearing cells which line the labyrinth is probably why they do not work so well; this leads to dulled hearing. As the pressure eases, the cells work better again, and hearing returns to normal. However, repeated bouts of increased pressure may eventually damage the hearing cells. This is why hearing loss may become permanent.

It is not clear why a build-up of fluid occurs in the labyrinth. There may be some fault where the amount of fluid made is more than the amount drained. A variety of factors may cause this. For example, slight abnormalities of the bones around the middle ear may be a factor. Inheritance may play some part. (About 8 in 100 close relatives of affected people develop Ménière’s disease compared with 1 in 1,000 of the general population. ) Other theories include viral infections of the ear, salt imbalance in the labyrinth fluid, diet and a faulty immune system.

Note: side-effects from some medicines can cause symptoms similar to Ménière’s disease, or make symptoms of Ménière’s disease worse. For example, some anticonvulsants, antidepressants, antihistamines, antipsychotics and sedatives. Tell your doctor if you think that a medicine that you are taking may be causing symptoms, or making them worse.

How is Ménière’s disease diagnosed?

Although the diagnosis is usually based on the typical symptoms, a hearing test (audiometry) is often performed. Typically, it shows low frequency loss in one ear. Ideally, it is best performed during an attack. However, this is often impractical as attacks usually come out of the blue and can make you feel ill. The diagnosis may only become clear over time as the typical pattern of recurring attacks develops.

Other conditions can cause similar symptoms to Ménière’s disease. For example, injury, infection, or tumours in the inner ear or nerve may cause deafness, noises in the ear (tinnitus) or dizziness with a spinning sensation (vertigo). However, Ménière’s disease is the likely cause if the symptoms are intermittent (that is, they come and go as attacks). Ear tests and scans may be advised in some cases to rule out other conditions. In particular, a scan will normally be needed if you have persistent symptoms of vertigo and/or hearing loss.

Ménière’s disease treatment

Understanding the cause of the symptoms is often helpful in itself. Although Ménière’s disease can be unpleasant, it is not due to cancer or to a brain or nerve disorder. There is no cure for Ménière’s disease but symptoms can be helped.

Treating attacks of vertigo

A short course of a medicine such as prochlorperazine or cinnarizine may ease dizziness and being sick (vomiting) when attacks of these symptoms occur. These medicines work by calming the nerve messages which are sent from the ear to the brain.

Many people have a warning feeling (an aura) just before an attack begins. If possible, medicine should be taken at this stage to prevent the attack from becoming worse or to lessen its severity. The medicine should be stopped when the attack of symptoms has gone.

Tablets may not be absorbed from the gut so well if there is vomiting. The absorption may be helped by:

• Using a medicine which is absorbed from within the mouth and gums straight into the bloodstream; or
• Using a medicine in suppository form; or
• Using a soluble form of medicine which may be absorbed quickly into the bloodstream.

The aim is to get the medicine into the body as soon as possible after symptoms begin. If one type of medicine does not help, see a doctor, as another type may be more suitable.

Sometimes an injection is needed to help stop severe dizziness and vomiting. A short course of steroids may be given as a last resort if the attack does not settle.

Preventing attacks of vertigo

If you have mild or infrequent attacks then you may not need or want any treatment to prevent the attacks. You may just prefer to treat each attack, as it arises, with one of the medicines mentioned above.

If needed, treatments which can help to prevent attacks include the following:

• Betahistine is a medicine that is thought to increase the blood flow around the inner ear. This may reduce the amount of fluid inside the labyrinth and prevent symptoms from developing. If you take betahistine every day it is unlikely to stop all attacks but it may reduce the number and/or severity of attacks. It does not work in all cases. A trial for 6-12 months of taking betahistine may be advised to see if it helps to reduce symptoms. If it does, it can be continued.
• Other medicines. These are sometimes tried on the advice of a specialist. For example, thiazide diuretics or beta-blockers may help in some cases.
• Intratympanic gentamicin. This treatment involves injecting a drug called gentamicin through your eardrum into the middle ear. This gives a very high concentration of the drug next to the affected inner ear. This drug works by damaging the nerve endings that send signals of balance down the vestibular nerve. It is only considered if you are greatly troubled with vertigo and other treatments have not helped. It works quite well but occasionally it can cause deafness and is less likely than surgery to relieve vertigo.
• Pressure pulse treatment (Meniett® device). This is a machine which generates a pulse of pressurised air into the ear canal and may be offered to you if your main problem is severe vertigo. The scientific evidence supporting this device is small, and further research is needed.
• Surgery to the inner ear. There are various operations. Surgery may be suggested if you have severe or frequently recurring attacks of vertigo that have not been helped by other treatments. Operations that may be considered include:
  • Micropressure therapy. This is the treatment that involves the least amount of surgery. A small tube (a grommet) is inserted through your eardrum into the middle ear and air is blown at low pressure into the inner ear. This reduces the pressure in the ear. The effectiveness of this treatment is still being researched.
  • Saccus decompression. This is an operation to reduce the pressure of the fluid in the labyrinth. This is another form of treatment that is still being studied to see how well it works.
  • Vestibular nerve section. This means that the nerve of balance is cut – which stops the abnormal signals of balance being sent to the brain.
  • Labyrinthectomy. This means totally destroying the inner ear. The big disadvantage of this is that the hearing part of your ear is destroyed in addition to the balance part. So, you will be totally deaf in the operated ear.

Diet and lifestyle

There is little research evidence to prove that diet and lifestyle can help. However, some people claim their symptoms improve by one or more of the following:

• A low-salt diet. This may help to reduce the fluid build-up in the inner ear.
• Regular exercise and methods to combat stress.
• Stopping smoking.
• Food triggers. There seems to be a link between migraine and Ménière’s disease. Food triggers are known to cause migraine attacks in some people. A similar trigger may contribute to some attacks of Ménière’s disease. For example, cutting out alcohol and also avoiding caffeine (found in tea, coffee, cola and chocolate) may be worth trying.

Other treatments are sometimes advised

For example:

• If you develop permanent hearing loss, you may benefit from a hearing aid.
• If loud sounds become distressing then an audiologist or hearing therapist can provide you with advice on compression hearing aids which may help to ease this symptom.
• If you develop permanent noises in the ear (tinnitus) then various strategies may be advised. For example, an audiologist or hearing therapist may advise on sound therapy. This is often a CD or on an MP3 player which plays soothing and relaxing sounds, helping to distract you from the sound of tinnitus.
• Some people have found coping strategies, relaxation training, counselling and other such techniques useful, particularly to combat tinnitus. See the separate leaflet called Tinnitus.
• A physiotherapist may be involved if your balance becomes permanently affected (in severe cases).

Some important safety points

If you are prone to sudden attacks of dizziness with a spinning sensation (vertigo) with little or no warning then:

• It is sensible always to carry some medication in case it is needed.
• Avoid heights, ladders, etc. Do not go swimming alone.

Make your home safe in case you fall whilst dizzy. In particular, if you have vertigo you are likely to go to bed until it eases. The trip to the bathroom may pass open stairs. It may be sensible to block the top of the stairs in case you fall.

If you are a driver, you must stop driving if Ménière’s disease is diagnosed and you must tell the Driver and Vehicle Licensing Agency (DVLA). This is because you may have sudden attacks of vertigo, or even drop attacks, with little warning. The DVLA will permit driving again if there is good control of symptoms. See the DVLA guide for details (the link is in Further reading below).

What is the outlook (prognosis)?

The way Ménière’s disease affects people can vary greatly. At the outset of the disease, it is not possible to predict how badly it will affect an individual in the coming years. In many cases, months or years go by between attacks. In some cases the attacks are more frequent. Some attacks are minor and don’t last long. Some attacks can be very distressing with severe sickness (vomiting) and dizziness. However, treatments that can ease symptoms have improved in recent years.

There is a good chance that after a while (typically after 5-10 years) the attacks stop occurring altogether. However, some permanent hearing loss or permanent noises in the ear (tinnitus) may have developed in the affected ear or ears by this time. This may be only a minor degree of hearing loss but some people become deaf in the affected ear or ears.

What helps, side effects, dosage

THERE ARE CONTRAINDICATIONS. POSSIBLE SIDE EFFECTS. A SPECIALIST’S CONSULTATION IS REQUIRED.

Author of the article

Dolgikh Natalia Vadimovna,

Diploma of Pharmaceutical Education: 105924 3510859 reg. number 31944

All authors

Contents of the article

• Betahistine: what the pills are for
• Betahistine: contraindications
• Betahistine: side effects
• Betahistine: dosage
• Betahistine: alternatives
• Betaserc or Betahistine: which is more effective? The disease is accompanied by bouts of tinnitus, loss of balance and dizziness. Often, to alleviate the condition of patients, the drug Betahistine is used.

  What kind of medicine is this, what does it help with, what are its contraindications and side effects, can it be replaced by other means – we addressed such questions to the pharmacist Natalia Dolgikh. We publish answers of the expert.

  All products Betahistine

  21 reviews

  Betahistine: what pills

  Betahistine contains the active substance of the same name. The drug eliminates dizziness in Meniere’s disease and other vestibular dizziness. It eliminates symptoms such as nausea, vomiting, tinnitus, hearing loss.

  Vertigo attacks in Meniere’s disease last from several minutes to several days. They exhaust the patient, cause discomfort, reduce performance. The drug Betahistine prevents seizures and improves the quality of life.

  There is currently no qualitative evidence that Betahistine reduces tinnitus or has a significant effect in Ménière’s disease. Low quality studies show efficacy for dizziness. The drug is well tolerated by patients.

  You may be interested in: Meniere’s disease: symptoms and signs

  Betahistine: contraindications

  The drug has a high safety profile. There are few contraindications, these include:

  • hypersensitivity to active and excipients of tablets
  • adrenal tumor
  • children under 18 years of age
  • pregnancy
  • lactation period

  For patients with bronchial asthma and gastrointestinal ulcers, Betahistine is prescribed under medical supervision.

  Betahistine side effects

  Betahistine is well tolerated by patients. Instructions for use indicates adverse reactions identified during clinical studies:

  • nausea and dyspepsia
  • headache

  Betahistine: dosage

  Betahistine is available in tablets of 8 mg, 16 mg and 24 mg. The daily dose is 24-48 mg. Tablets are taken 2-3 times a day, the treatment regimen and dosage are set individually for each patient.

  Often the first results are achieved only after a few weeks of therapy, and the maximum effect after a few months of treatment. It has been established that taking the drug at an early stage of Meniere’s disease stops its development and hearing loss in the future.

  Betahistine: analogues

  There are many analogues on the market with the active ingredient betahistine. Basically, these are drugs of Russian pharmaceutical companies. The funds bear the same name with the indication of the brand of the manufacturer. For example, Betagistin Reneval or Betagistin-Akrikhin. Dosages, indications for use, contraindications are identical. From foreign analogues in Russian pharmacies you can buy:

  • Betaserc
  • Vertrand
  • Vestibo
  • Tagista

  All products Betaserc

  23 reviews

  All products Vertran

  5 reviews

  All products Tagista

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  All products Vestibo

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  Betaserc or Betahistine: which is more effective

  9003 0 Betaserc and Betahistine contain the same active ingredient – betahistine hydrochloride.

  Betaserc is the original product of the Dutch company Abbott Healthcare Products. It has been studied in numerous clinical studies that have confirmed its efficacy and safety. Betaserc eliminates dizziness, noise and ringing in the ears, reduces the number of attacks and prevents hearing loss.

  Betahistine is a copy of Betaserc. It is difficult to assess which is better – Betaserc or Betahistine. The difference in the effectiveness of the original drug and the copy may be associated with substances and excipients.

  Summary

  • Betahistine – tablets for dizziness, noise, tinnitus, loss of balance, nausea and hearing loss in Meniere’s disease.
  • Betahistine has three contraindications: hypersensitivity, adrenal tumor and age under 18 years.
  • Betahistine is well tolerated with few side effects.
  • Betahistine is available in 8 mg, 16 mg and 24 mg tablets. Take 2-3 times a day. The daily dose and course of treatment is prescribed individually.
  • The most popular analogues: Betaserc, Tagista and Vestibo.

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  Main: range, components and benefits

  Main: range, components and benefits | Vertigochel

  1. home

  2. About Vertigoheel

  Patient preferences when it comes to dosage forms are as varied as the symptoms of vertigo. Some find it difficult to swallow tablets, while others are reluctant to take drops containing ethyl alcohol. However, each patient can choose the most appropriate dosage form of Vertigochel.

  • Vertigochel tablets
  • Vertigoheel drops
  • Vertigochel Ampoules

  Vertigoheel tablets

  Most patients prefer to dissolve the dizziness tablet in the mouth. Vertigoheel tablets with a pleasant taste are available in packs of 50, 100 and 250 tablets.

  Vertigochel Tablets – doses

  Adults and children 12 years and older

  Unless otherwise directed by a physician, dissolve in mouth 1 tablet 3 times daily; in acute cases, dissolve 1 tablet every hour or half an hour, but not more than 12 tablets per day. After consultation with your doctor, you can increase the dose to 3 tablets 3 times a day, if necessary.

  Please check product availability in your country.

  DETAILS

  Vertigochel Drops

  Drops are easy to take. Drops for oral administration contain 35% ethyl alcohol by volume. They are available in 30 ml and 100 ml bottles.

  Vertigoheel drops – doses

  Adults and children 12 years and older

  Unless otherwise prescribed by a doctor, the adult dose is 10 drops 3 times a day. In acute cases, take 10 drops every hour or half an hour, but not more than 12 times a day.

  Please check product availability in your country.

  MORE DETAILS

  Vertigochel Ampoules

  Injectable solution in ampoules allows the doctor to administer the drug by injection. Each ampoule of Vertigochel contains 1.1 ml of solution for injection. Available in packs of 5, 10, 50 and 100 ampoules.

  Vertigoheel ampoules – doses

  Adults and children 12 years and older

  Unless otherwise prescribed by a physician, adults are administered 1 ampule 1-3 times a week.

  In acute cases, administer 1 ampoule daily, then continue at the standard dose.

  Route of administration:
  Vertigochel injection can be administered subcutaneously, intradermally, intramuscularly or intravenously.

  Please check product availability in your country.

  DETAILS

  Well tolerated

  Vertigoheel is a drug for the treatment of dizziness without identified side effects.
  

  Vertigoheel has no identified side effects and does not interact with other drugs.

  Elderly patients often suffer from various chronic diseases and have to take several medications at the same time. Side effects and drug interactions can be detrimental. Vertigochel is a drug for the treatment of vertigo with no known side effects and no drug interactions – a clear advantage over many other drugs

  Vertigoheel does not have a sedative effect

  Another advantage: Vertigochel does not have a sedative effect. It does not cause fatigue and does not affect concentration. This positively affects the so-called central compensation, that is, the ability of the brain to compensate for dizziness on its own over time.

  However, many drugs for dizziness, obtained by chemical synthesis, worsen the condition of the central nervous system.