{
  "schema_version": 1,
  "kind": "condition",
  "id": "vertigo",
  "name": "Peripheral vertigo (BPPV & vestibular neuronitis)",
  "category": "chronic",
  "sources": "NICE CKS Vertigo 2022 · Betahistine 16 mg tablets SmPC sections 4.1-4.4 (eMC product 7053) · Dramamine Original 50 mg tablets, Directions (DailyMed SetID f9302a5a-295a-4501-9332-e3f5eb387362)",
  "review_status": "reviewed",
  "verified_against": "Betahistine 16 mg tablets SmPC sections 4.1-4.4 (eMC product 7053) · Dramamine Original 50 mg tablets, Directions (DailyMed SetID f9302a5a-295a-4501-9332-e3f5eb387362)",
  "verified_date": "2026-08",
  "treatments": [
    {
      "id": 1945,
      "generic": "Dimenhydrinate",
      "line": 1,
      "is_adjunct": false,
      "form": "oral.solid",
      "strength_mg": 50.0,
      "adult_dose": "50-100 mg orally every 4-6 hours (max 400 mg/day)",
      "adult_duration": "short-term (1-3 days during acute phase)",
      "dose_source": "Dramamine Original 50 mg tablets, Directions (DailyMed SetID f9302a5a-295a-4501-9332-e3f5eb387362)",
      "rationale": "Antihistamine with anticholinergic and antiemetic activity that suppresses vestibular nuclei signalling and the associated nausea; first-line short-term drug therapy for acute vestibular neuronitis, while BPPV itself is treated with the Epley manoeuvre rather than medication.",
      "cautions": [
        "First-line for acute vestibular neuronitis (short-term only, max 3-5 days); BPPV requires Epley maneuver, not medication.",
        "Sedation and anticholinergic side effects (dry mouth, blurred vision) are common.",
        "Use strictly for acute severe vertigo; long-term use impairs compensation.",
        "Avoid driving or operating machinery."
      ],
      "peds_mgkg_low": null,
      "peds_mgkg_high": null,
      "peds_max_mg": null,
      "peds_basis": null,
      "peds_unit": null,
      "peds_note": "Children 6 to under 12 years: half to one 50 mg tablet every 6-8 hours, not more than 3 tablets in 24 hours. Children 2 to under 6 years: half a tablet every 6-8 hours, not more than one and a half tablets in 24 hours.",
      "peds_min_weight_kg": null,
      "peds_max_weight_kg": null,
      "peds_age_min_months": null,
      "peds_age_max_months": null,
      "peds_age_bands": [
        {
          "label": "2 to under 6 years",
          "age_min_months": 24,
          "age_max_months": 71,
          "dose_text": "Half a 50 mg tablet every 6 to 8 hours, and no more than one and a half tablets in 24 hours"
        },
        {
          "label": "6 to under 12 years",
          "age_min_months": 72,
          "age_max_months": 143,
          "dose_text": "Half to one 50 mg tablet every 6 to 8 hours, and no more than 3 tablets in 24 hours"
        }
      ],
      "peds_doses": null,
      "brands": [
        {
          "trade_name": "DRAMENEX 50MG 20 TABS.",
          "scientific_name": null,
          "normalized_ingredient": null,
          "manufacturer": "KAHIRA",
          "price_egp": 28.0,
          "pack_count": 20,
          "unit_price": 1.4,
          "strength_mg": 50.0,
          "exact_strength": true,
          "exact_form": true,
          "discontinued": false,
          "also_contains": null
        }
      ],
      "condition_id": "vertigo"
    }
  ]
}