4.6.2 Drugs for the treatment of labyrinthine vertigo

ChoiceDrugDosage
1st choicesCinnarizine tablets 15mgDose:
15-30mg three times daily
Or
Prochlorperazine tablets 5mg; syrup 5mg/mlDose:
5mg three times daily, gradually increased if required to 30mg daily in divided doses, and reduced after several weeks to 5-10mg daily

Prescribing Notes

  • These products are only effective for labyrinthine vertigo.
  • Prochlorperazine buccal tablets may be a suitable alternative for patients who are vomiting.

Cautions

  • Prochlorperazine should not be prescribed for “dizziness” in older patients due to the risk of drug-induced parkinsonism, postural hypotension and mental confusion.
  • Prolonged use of cinnarizine in the treatment of labyrinthine vertigo can cause tremor.
  • Betahistine use may delay labyrinthine rehabilitation.
  • Patients prescribed drugs for the treatment of nausea and vertigo should be reviewed regularly and medicines which are not of benefit should be stopped.