Vertigo is a sensation of spinning or dizziness, often accompanied by feelings of unsteadiness, nausea, or vomiting. This disorienting experience can make it feel as though you or your surroundings are moving. Many individuals encounter mild, temporary episodes of vertigo and may explore readily available over-the-counter options for relief. Understanding these options can help manage symptoms when they arise.
Over-the-Counter Medications for Vertigo
Antihistamines are commonly used to alleviate symptoms of vertigo. These medications work by affecting specific pathways in the brain that influence balance and the sensation of motion. They can help calm the inner ear’s response to motion, which often contributes to vertigo.
Meclizine, often found under brand names like Bonine or Dramamine Less Drowsy Formula, is an antihistamine frequently recommended for vertigo and motion sickness. This medication primarily acts by depressing excitability in the labyrinth, a part of the inner ear involved in balance, and by affecting vestibular-cerebellar pathways. Its antiemetic properties, which reduce nausea and vomiting, are linked to its central anticholinergic and central nervous system (CNS) depressant effects.
For adults and children 12 years or older, a typical dosage for vertigo associated with vestibular system diseases ranges from 25 to 100 milligrams (mg) daily, which may be administered in divided doses. If used for motion sickness, a dose of 25 to 50 mg can be taken orally about one hour before exposure to motion, and then every 24 hours as needed.
Meclizine can cause side effects, with drowsiness, fatigue, and dry mouth being common occurrences. Less frequently, it may lead to blurred vision, headache, or gastrointestinal issues like constipation or diarrhea. Due to the potential for drowsiness, individuals should avoid driving or operating heavy machinery until they understand how the medication affects them. Alcohol consumption should also be limited or avoided, as it can worsen drowsiness.
Those with angle-closure glaucoma or prostatic enlargement should consult a doctor before use due to the medication’s anticholinergic effects. Meclizine is also not recommended for children younger than 12 years unless advised by a physician. Taking meclizine with other CNS depressants, such as tranquilizers, sedatives, or alcohol, can increase the risk of excessive sedation.
Dimenhydrinate, commonly known by the brand name Dramamine, is another antihistamine used to manage nausea, vomiting, and vertigo related to motion sickness. This medication combines diphenhydramine, an antihistamine, and 8-chlorotheophylline, a mild stimulant. While the primary therapeutic effects come from diphenhydramine, the stimulant component is thought to help counteract some of the drowsiness. Dimenhydrinate works by blocking histamine H1 receptors in the central nervous system, which helps to inhibit vestibular stimulation and reduce dizziness and nausea.
For adults and children over 12 years, a typical oral dose of dimenhydrinate is 50 mg every 4 to 6 hours, not exceeding a maximum of 400 mg in 24 hours. Children between 6 and 12 years old may take 25-50 mg orally every 6-8 hours, with a maximum of 150 mg in 24 hours. For children between 2 and 6 years, the dosage is generally 12.5-25 mg orally every 6-8 hours, not to exceed 75 mg in 24 hours.
Common side effects of dimenhydrinate include drowsiness, dizziness, and dry mouth. Other possible effects include headache, blurred vision, or ringing in the ears (tinnitus). Like meclizine, dimenhydrinate can impair judgment and coordination, so activities requiring alertness, such as driving or operating machinery, should be avoided until its effects are known.
Those with glaucoma, an enlarged prostate, or chronic lung disease should use dimenhydrinate with caution. Dimenhydrinate can also mask the early signs of ear toxicity, so it should be used cautiously in patients taking other drugs known to be ototoxic. Pregnant or nursing mothers should consult their doctor before using dimenhydrinate.
When to Seek Professional Medical Attention
While over-the-counter medications can provide relief for mild vertigo, certain symptoms indicate a need for prompt medical evaluation. If vertigo has a sudden and severe onset, or if it is accompanied by new or worsening headaches, double vision, or weakness, seek medical attention. Other concerning signs include numbness, difficulty speaking, significant hearing loss, persistent ringing in the ears (tinnitus), a high fever, or any loss of consciousness.
If vertigo is persistent, recurs frequently, or worsens despite consistent use of over-the-counter treatments, seek professional medical help. Vertigo can sometimes be a symptom of more serious underlying conditions that require a precise diagnosis and specialized treatment. A healthcare provider can determine the cause of the vertigo and recommend appropriate interventions beyond self-care.