4 medications for vertigo

Vertigo is a distinct form of dizziness. When you have vertigo, you might have the sensation of rotational motion.

Vertigo is often the result of a condition known as benign paroxysmal positional vertigo (BPPV).

This is where calcium crystals located in the inner ear become loose, resulting in a spinning sensation whenever your head changes position.

Several other health conditions can result in vertigo, such as strokes and medication side effects.

Vertigo medication list

Once a doctor rules out other causes, they might recommend medication to treat your symptoms, depending on what’s causing your vertigo.

Diazepam

Diazepam (Valium) is in the benzodiazepine class of medications. It works by calming overactivity in the brain and can help treat various conditions such as anxiety, muscle spasms, and seizures.

Diazepam can treat vertigo symptoms during acute episodes. It’s available as a tablet, solution, or concentrate. You take it orally with or without food.

If you have the concentration, you should dilute it according to directions before taking it.  

A common dose is 2–10 milligrams (mg) orally every 4–8 hours. It’s also possible to receive your dose intravenously (IV).

Like with all medications, diazepam can cause side effects.

These include:

• drowsiness
• dizziness 
• fatigue (low energy)
• muscle weakness
• dry mouth
• nausea
• constipation

Diazepam can also cause serious side effects. You should get medical help immediately if you experience any of the following:

• uncontrollable shaking
• slurred speech
• slowed heart rate
• slowed breathing
• loss of body movements

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Lorazepam

A doctor might prescribe a different benzodiazepine medication to treat vertigo, such as lorazepam (Ativan). It works similarly to diazepam by helping to treat acute attacks of vertigo.

A common dose of lorazepam for vertigo is 1–2 mg orally every 4 hours. 

Lorazepam can cause several side effects such as:

• dry mouth
• constipation
• muscle weakness
• fatigue

It can also cause serious side effects such as:

• fine tremor or restlessness
• shuffling walk
• speech problems
• irregular heart rate
• yellowing eyes or skin
• wheezing or shortness of breath
• rash, hives, or itchiness
• swelling of the face

If you experience any serious side effects, you should get medical support immediately.

Meclizine

Meclizine (Antivert) is a medication that can help prevent symptoms of motion sickness, including dizziness, nausea, and vomiting.

It’s in the antihistamine class of medications that can prevent signaling in the brain that causes dizziness.

Meclizine is particularly effective for vertigo caused by inner ear conditions such as BPPV. It’s available as a regular tablet, a chewable tablet, or a capsule. 

A serious side effect of meclizine is blurred vision. If you experience blurry vision while taking meclizine, you should get medical support immediately.  

Common side effects you might experience with this medication are:

• drowsiness
• fatigue
• dry mouth

A doctor may recommend 25–100 mg daily to begin with and then adjust according to how the medication works for you.  

Promethazine

Promethazine (Phenergan) is also an antihistamine, but it works a bit differently than meclizine.

It acts on some of the brain’s dopamine and alpha-adrenergic receptors to reduce symptoms like nausea, vomiting, and motion sickness.

Promethazine is available in several different forms, including a tablet, syrup, and rectal suppository.

A doctor can also give this drug via IV or intramuscular injection.

The usual dose of promethazine is 25 mg taken twice daily. Some recommend 25 mg every 6 hours if taken orally or by intramuscular injection, or every 4–12 hours if taken by rectal suppository. 

It can cause several side effects such as:

• dry mouth
• drowsiness
• nausea or vomiting
• blurred or double vision
• ringing in the ears
• loss of coordination
• itching
• unusually happy mood

This medication can also cause serious side effects. Seek immediate medical support if you experience any of the following after taking promethazine:

• wheezing or breathing changes
• fever or sweating
• hallucinations or confusion
• stiff muscles or uncontrolled body movements
• seizures
• rash or hives
• swelling
• yellowing of the skin or eyes

How to choose the right vertigo medication 

It can be helpful to discuss your medication options with a doctor. Some factors to consider are:

• Other medications you’re taking: You should only take some medications together with extreme caution, such as opioids and diazepam.
• Potential side effects: Some drug options, such as diazepam, might also be habit-forming or can lead to dependence. 
• Condition causing your vertigo: BPPV symptoms include ringing in the ears (tinnitus) and hearing loss. If BPPV causes your vertigo, some medications like meclizine might be particularly effective.
• Timing and form of dosage: You might want to take a medication in a specific form, such as a tablet or liquid, and at a frequency that’s easier for you. 

You might also want to discuss changing your medication with a doctor if your current medication is not effective or has unwanted side effects.

Summary

Several medications are available to treat vertigo.

These typically include benzodiazepines and antihistamines. But it’s important to know that some of these medications can cause serious side effects, and you shouldn’t take them with other drugs. 

Consider discussing the symptoms you’re experiencing with a doctor. They can help identify the best treatment options specific to your needs.

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