Medication

Below is an overview of the medication often prescribed for vertigo. This information is not intended to replace specific medical advice from your GP, consultant, specialist or pharmacist, but to give a general description of the medication currently prescribed.

Betahistine

Betahistine is a histamine analog and is a prescription only medication. It is also known by the brand name Serc. Betahistine is one of the most commonly prescribed drugs used to treat vertigo, tinnitus and hearing loss associated with Ménière’s disease in the UK. It works by acting on histamine receptors that are found in the walls of blood vessels in the inner ear. By activating these receptors, a process is started which is thought to reduce the pressure of the fluid that fills the labyrinth in the inner ear. This helps to relieve the symptoms associated with Ménière’s disease.

Prochlorperazine

Prochlorperazine, also known by the brand name Stemetil, is an anti-sickness drug which acts to reduce the impact of the abnormal signals coming from the balance organ helping to relieve the symptoms of nausea, vomiting and vertigo associated with Ménière’s disease, labyrinthitis and other inner ear disorders. It is a prescription only medication available as a tablet, injection and buccal preparation (Buccastem). It is usually taken as needed, rather than on a regular basis. Prochlorperazine affects the dopamine receptors in an area of the brain that controls nausea and vomiting. Vomiting is controlled by an area of the brain called the vomiting centre. The vomiting centre is responsible for causing feelings of sickness and for the vomiting reflex. It is activated when it receives nerve messages from another area of the brain called the chemoreceptor trigger zone and when it receives nerve messages from the gut. Prochlorperazine controls nausea and vomiting by blocking dopamine receptors found in the trigger zone and prevents it from sending messages to the vomiting centre that would otherwise cause nausea and vomiting.

Cinnarizine

Cinnarizine is an antihistamine medication used to control travel and motion sickness. It is also known as Stugeron and is available from chemists without prescription. Cinnarizine is used to treat the symptoms of nausea, vomiting, vertigo and tinnitus associated with Ménière’s disease as well as disorders of the middle ear. Cinnarizine has two pharmacological actions. It is a calcium antagonist, though not a powerful one. This acts mainly on the blood vessels and prevents constriction on these vessels. In theory it therefore improves the micro circulation of the ear. At the same time it has a mild antihistaminic effect.

Cinnarizine and Dimenhydrinate

The combination medication of Cinnarizine and Dimenhydrinate has been licensed in the UK for the treatment of vertigo with mixed origins since 2007 and has been available in Germany since 1982. It is also known in the UK by the brand name Arlevert. Cinnarizine and dimenhydrinate is a prescription only medication used to treat vertigo of various origins (central and/or peripheral vertigo), including otogenic vertigo, vertigo because of vestibular neuropathy, Ménière’s disease, Ménière-like syndrome and vertigo because of vertebrobasilar insufficiency. The usual prescription is one tablet three times a day, taken with water after meals. Due to its specific calcium antagonistic properties, cinnarizine acts mainly as a vestibular sedative through inhibition of the calcium influx into the vestibular sensory cells. Cinnarizine thus acts predominantly on the peripheral vestibular system. Dimenhydrinate exhibits anti-emetic and anti-vertiginous effects through influencing the chemoreceptor trigger zone in the region of the 4th ventricle. Dimenhydrinate thus acts predominantly on the central vestibular system.

Domperidone

Domperidone is a dopamine antagonist, also known by the brand name Motilium. It is used to treat nausea and vomiting and is also used to relieve stomach discomfort, bloating and reflux or heartburn by helping food to move faster through your digestive system to help prevent feelings of sickness, bloating and regurgitation. Domperidone is available as a suppository, tablet or oral suspension. Suppositories are available on prescription only. Some tablets containing the active ingredient domperidone are available from pharmacists over the counter.

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