From the Guidelines
For vertigo in pregnancy, the recommended pharmacological treatment options are limited, but cyclizine, prochlorperazine, and promethazine are considered compatible with use during pregnancy, particularly in the second and third trimesters 1. When considering treatment for vertigo in pregnancy, it's essential to prioritize non-pharmacological approaches first, such as:
- Adequate hydration
- Getting plenty of rest
- Avoiding sudden movements
- Eating small, frequent meals to prevent nausea If medication is necessary, the following options can be considered:
- Cyclizine: a first-line recommended treatment for hyperemesis gravidarum, which can also be used for vertigo
- Prochlorperazine: a first-line recommended treatment for hyperemesis gravidarum, which can also be used for vertigo
- Promethazine: a first-line recommended treatment for hyperemesis gravidarum, which can also be used for vertigo These medications should be used at the lowest effective dose for the shortest duration possible, and under medical supervision. It's crucial to note that while these drugs are considered relatively safe in pregnancy, they should still be used with caution and under the guidance of a healthcare provider. The rationale for using these medications is that they can help reduce the sensitivity of the vestibular system, which is responsible for balance, and also have anti-emetic properties, which can help with associated nausea. Always consult with your obstetrician before starting any medication during pregnancy, as individual circumstances may affect the choice of treatment.
From the FDA Drug Label
Meclizine hydrochloride tablets are indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults. There is no information in the provided drug labels that directly addresses the treatment of vertigo in pregnancy. The FDA drug label does not answer the question.
From the Research
Pharmacological Treatment Options for Vertigo in Pregnancy
The following pharmacological treatment options are considered relatively safe for vertigo in pregnancy:
- Meclizine and dimenhydrinate, as antiemetics in vertigo attacks 2
- Metoclopramide, vitamin B6 and ginger rhizome, alternatively 2
- Low-dose diazepam and diuretics in severe cases of Meniere's disease (with caution) 2
- Systemic administration of prednisone and prednisolone can be considered in selected cases 2
Contraindicated Medications
The following medications are contraindicated in pregnancy:
Management of Vertigo
Supportive treatment, antiemetic and vestibular blocking agents help relieve an acute vertigo attack 4 Vestibular rehabilitation programs can be considered for unilateral peripheral vestibular disorder 4 A simple program including patient education and home based exercises can be sufficient 4