Does meclizine treat Benign Paroxysmal Positional Vertigo (bppv)?

From the FDA Drug Label

MECLIZINE HYDROCHLORIDE tablets, for oral use Initial U. S. Approval: 1957 INDICATIONS AND USAGE Meclizine hydrochloride tablets are indicated for the treatment of vertigo associated with diseases affecting the vestibular system in adults (1).

The FDA drug label does not explicitly state that meclizine treats Benign Paroxysmal Positional Vertigo (BPPV), but it does indicate that meclizine is used to treat vertigo associated with diseases affecting the vestibular system. However, BPPV is a specific condition that affects the vestibular system, and the label does not directly confirm its effectiveness for this condition. Therefore, based on the available information, it can be inferred that meclizine may be used to treat vertigo, but its effectiveness for BPPV is not directly confirmed by the label 1.

From the Research

Treatment of Benign Paroxysmal Positional Vertigo (BPPV)

• BPPV can be treated with canalith-repositioning maneuvers, such as the Epley maneuver 2, 3, 4
• The use of meclizine, a vestibular suppressant medication, is not recommended for the treatment of BPPV, as it is not indicated and may have side effects 2, 3
• Some studies suggest that anti-vertigo medications, such as betahistine and dimenhydrinate, may be effective in reducing symptoms of BPPV, especially in severe cases 5, 6
• The Epley maneuver is considered the primary treatment for BPPV, and its application can reduce resource utilization, ED length of stay, and the use of ineffective medications 3
• A comparative study found that the combination of drugs and the Epley maneuver was more effective than drugs alone in managing BPPV 6

Efficacy of Different Treatments

• The canalith repositioning procedure has a high success rate, with 92.1% of patients experiencing relief from vertigo 4
• The Epley maneuver is easy and safe to perform, noninvasive, and can be repeated if needed 3, 4
• Betahistine and dimenhydrinate may be effective in reducing symptoms of BPPV, but their use should be considered on a case-by-case basis 5, 6

Diagnosis and Management

• BPPV can be diagnosed using bedside tests, such as the Dix-Hallpike test, and treated with bedside positional maneuvers, such as the Epley maneuver 2, 3
• Imaging studies, such as CT or MRI, are not necessary for the diagnosis of BPPV, unless other conditions are suspected 2, 3
• Patients with BPPV may not be managed optimally in the emergency department, with overuse of imaging and ineffective medications 2, 3