Pharmacotherapy of dizziness of various genesis: in search of the only right solution

10 серпня 2023
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УДК:  616.28-008.55
Спеціальності :
Резюме

Primary care physicians often encounter complaints of dizziness of uncertain genesis in patients, which requires additional examination to clarify the nature of the condition. In order to improve the condition of patients who are somewhat disabled due to dizziness and have a high risk of falling or being injured, a fixed combination of cinnarizine/dimenhydrinate (Arlevert®) may be recommended, which, according to evidence-based medicine, is considered the first-line drug for the pharmacological correction of central and peripheral dizziness. The multifaceted mechanism of action and synergistic activity of the two active ingredients ensure high clinical efficacy of the drug: a short 4-week course of treatment with Arlevert® effectively eliminates dizziness and concomitant autonomic symptoms (nausea, vomiting), surpassing alternative drugs in terms of its effectiveness, and does not require dose titration. Evidence-based medicine suggests that a fixed combination of cinnarizine/dimenhydrinate (Arlevert®) may be the right solution to combat with various causes of dizziness.

References

1. Neuhauser H.K (2016) Chapter 5 — The epidemiology of dizziness and vertigo. J.M. Furman, Th. Lempert (Eds.). Handbook of Clinical Neurology. Elsevier, 137: 67–82. doi.org/10.1016/B978-0-444-63437-5.00005-4.

2. Murphy C., Reinhardt C., Linehan D. et al. (2022) A review of primary care referrals for patients with dizziness and vertigo: prevalence and demographics. Ir. J. Med. Sci., 191(1): 385–389. doi: 10.1007/s11845-021-02575-6.

3. Cinnarizine/dimenhydrinate for vertigo (2021) Aust Prescr., 44(2): 62–63. doi: 10.18773/austprescr.2021.009.

4. Swain S. (2020) Pharmacotherapy for vertigo: a current perspective. Int. J. Otorhinolaryngol. Head Neck Surg., 6(7): 1400–1406.

5. Kirtane M., Bhandari A., Narang P. et al. (2019) Cinnarizine: A Contemporary Review. Indian J. Otolaryngol. Head Neck Surg, 71(Suppl. 2): 1060–1068. doi: 10.1007/s12070-017-1120-7.

6. Schremmer D., Bognar-Steinberg I., Baumann W. et al. (1999) Efficacy and Tolerability of a Fixed Combination of Cinnarizine and Dimenhydrinate in Treatment of Vertigo. Clin. Drug Investig., 18: 355–368. doi.org/10.2165/00044011-199918050-00003.

7. Scholtz A., Ilgner J., Loader B. et al. (2016) Cinnarizine and dimenhydrinate in the treatment of vertigo in medical practice. Wien Klin Wochenschr., 128(9–10): 341–347. doi: 10.1007/s00508-015-0905-5.

8. Plescia F., Salvago P., Dispenza F. et al. (2021) Efficacy and Pharmacological Appropriateness of Cinnarizine and Dimenhydrinate in the Treatment of Vertigo and Related Symptoms. Int. J. Environ Res. Public Health, 18(9): 4787. doi: 10.3390/ijerph18094787.

9. Scholtz A., Steindl R., Burchardi N. et al. (2012) Comparison of the therapeutic efficacy of a fixed low-dose combination of cinnarizine and dimenhydrinate with betahistine in vestibular neuritis: a randomized, double-blind, non-inferiority study. Clin. Drug Investig., 32(6): 387–399. doi: 10.2165/11632410-000000000-00000.

10. Scholtz A., Hahn A., Stefflova B. et al. (2019) Efficacy and Safety of a Fixed Combination of Cinnarizine 20 mg and Dimenhydrinate 40 mg vs Betahistine Dihydrochloride 16 mg in Patients with Peripheral Vestibular Vertigo: A Prospective, Multinational, Multicenter, Double-Blind, Randomized, Non-inferiority Clinical Trial. Clin. Drug Investig., 39(11): 1045–1056. doi: 10.1007/s40261-019-00858-6.

11. Cristopher G., Francis R., Norberto M. (2017) Efficacy of Cinnarizine/Dimenhydrinate Compared to Betahistine in the Management of Adults with Peripheral Vestibular Disorder: A Meta-Analysis. www.jmust.org/elib/journal/doi/10.35460/2546-1621.2017-0007/pdf.

12. Scholtz A., Waldfahrer F., Hampel R. et al. (2022) Efficacy and Safety of a Fixed-Dose Combination of Cinnarizine 20 mg and Dimenhydrinate 40 mg in the Treatment of Patients with Vestibular Vertigo: An Individual Patient Data Meta-Analysis of Randomised, Double-Blind, Controlled Clinical Trials. Clin. Drug Investig., 42(9): 705–720. doi: 10.1007/s40261-022-01184-0.