Drugs Used in Nausea and Vertigo

Preferred list (P)

CINNARIZINE

• May be used short–term for the acute treatment of Ménière’s disease.

CYCLIZINE

• Cyclizine has the potential for abuse.

Preferred list (P)

PROCHLORPERAZINE

• Prochlorperazine should not be prescribed for “dizziness” in older patients due to the risk of drug–induced parkinsonism, postural hypotension and mental confusion. Long-term use in older patients may cause tardive dyskinesia.
• Prochlorperazine buccal tablets may be a suitable alternative for patients who are vomiting.
• Prochlorperazine may be used short–term for the acute treatment of Ménière’s disease.

Total list (T)

METOCLOPRAMIDE

• Metoclopramide has been associated with neurological adverse effects. 
• See  MHRA Drug Safety Update August 2013: Metoclopramide: risk of neurological adverse effects  for further information, including restricted dose and duration of use.

DOMPERIDONE

• Domperidone is not licensed for use in children younger than 12 years or those weighing less than 35 kg.
• Domperidone is associated with a small increased risk of serious cardiac side effects.
• For further information, see MHRA links below:
  • MHRA Drug Safety Update December 2019 - Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents
  • MHRA Drug Safety Update April 2016 - Apomorphine with domperidone: minimising risk of cardiac side effects
  • MHRA Drug Safety Update December 2014 -  Domperidone: risks of cardiac side effects

Preferred list (P)

BETAHISTINE

• Betahistine should be reserved for prophylaxis in patients with a proven diagnosis of Ménière’s disease.