What can I take instead of betahistine for vertigo? A Guide to Alternatives

October 6, 2025 •

4 min read

Nearly 40% of U.S. adults experience vertigo at least once in their lifetime [1.8.3]. If you're wondering what can I take instead of betahistine for vertigo, several effective alternatives exist, ranging from other medications and supplements to targeted physical therapies.

Quick Summary

Find effective alternatives to betahistine for managing vertigo. This overview covers prescription drugs, over-the-counter options, and non-pharmacological therapies for lasting relief from dizziness and spinning sensations.

Key Points

Diagnosis is Key: The best alternative depends on the underlying cause of vertigo, such as BPPV, Meniere's disease, or vestibular neuritis [1.2.4].
Prescription Options: Antihistamines (meclizine), benzodiazepines (diazepam), and antiemetics (prochlorperazine) are common medical alternatives to betahistine [1.2.1, 1.2.2].
Meniere's Disease Specifics: Diuretics (like HCTZ) are often used specifically for vertigo associated with Meniere's disease to reduce inner ear fluid pressure [1.2.1, 1.2.5].
Effective Physical Therapy: For BPPV, Canalith Repositioning Procedures like the Epley Maneuver are highly effective, while Vestibular Rehabilitation Therapy (VRT) helps manage chronic dizziness [1.5.2, 1.6.1].
OTC and Natural Relief: Over-the-counter antihistamines like meclizine and dimenhydrinate are accessible options, and supplements like ginger may help with nausea [1.4.1, 1.4.2].
Betahistine in the U.S.: Betahistine is not FDA-approved in the U.S. due to a perceived lack of evidence for its efficacy, but it can be obtained via a compounding pharmacy with a prescription [1.9.1, 1.9.2].
Consult a Professional: Always consult a doctor to determine the cause of your vertigo and receive a safe and effective treatment plan [1.2.2].

Vertigo, the sensation of spinning or dizziness, can be a debilitating condition. While betahistine is a common treatment in many countries, it is not approved by the FDA in the United States, leading many to seek alternatives [1.9.1, 1.9.5]. Understanding the available options is the first step toward finding relief.

Understanding Vertigo and the Role of Betahistine

Vertigo isn't a disease itself, but a symptom of an underlying condition affecting the vestibular system in the inner ear, which controls balance [1.8.3]. Common causes include Benign Paroxysmal Positional Vertigo (BPPV), Meniere's disease, and vestibular neuritis [1.5.3, 1.5.5].

Betahistine is thought to work by improving blood flow to the inner ear, which can help reduce the frequency and severity of vertigo attacks, particularly in those with Meniere's disease [1.2.1, 1.9.5]. However, due to its unapproved status in the U.S., which stems from what the FDA deemed insufficient evidence of efficacy, patients and doctors often turn to other treatments [1.9.1, 1.9.2]. It is available in the U.S. through compounding pharmacies with a prescription [1.9.1].

Prescription Medication Alternatives to Betahistine

A healthcare provider may prescribe various classes of drugs to manage vertigo symptoms, depending on the cause and severity.

Antihistamines

Certain antihistamines are effective at managing vertigo, nausea, and motion sickness. They work by suppressing the vestibular system [1.2.2].

Meclizine (Antivert, Bonine): Available both over-the-counter and by prescription, meclizine is widely used to treat vertigo and dizziness [1.4.2, 1.4.5].
Dimenhydrinate (Dramamine): Another common OTC option that helps reduce the sensation of spinning and nausea [1.2.1, 1.4.3].
Promethazine: A prescription antihistamine that also has strong anti-nausea effects [1.2.1, 1.3.1].

Benzodiazepines

These drugs act as vestibular suppressants and can be very effective for severe, acute vertigo attacks. Due to the risk of dependency, they are typically prescribed for short-term use [1.2.6].

Diazepam (Valium): Provides vestibular suppression and helps with the anxiety that can accompany severe vertigo [1.3.2, 1.3.3].
Lorazepam (Ativan): Used to suppress the vestibular system and control acute symptoms [1.2.1, 1.3.5].

Antiemetics (Anti-nausea Medications)

When nausea and vomiting are the primary symptoms alongside vertigo, antiemetics are used to provide relief [1.2.1].

Prochlorperazine (Compazine): A phenothiazine antiemetic that helps control severe nausea [1.2.4, 1.2.6].
Ondansetron (Zofran): Often used to manage nausea associated with vertigo [1.3.5, 1.3.6].

Diuretics

For vertigo specifically caused by Meniere's disease, diuretics (water pills) may be prescribed to reduce fluid volume and pressure in the inner ear [1.2.5, 1.3.1]. Examples include hydrochlorothiazide (HCTZ) [1.2.1].

Anticholinergics

Scopolamine: Typically administered as a transdermal patch, it is effective for motion sickness and some forms of vertigo by inhibiting nerve signals from the inner ear [1.2.4, 1.2.6].

Comparison of Common Vertigo Medications


Medication	Class	How it Works	Common Side Effects	Best For
Meclizine	Antihistamine, Anticholinergic	Blocks histamine and cholinergic signals from the inner ear to the brain [1.4.5].	Drowsiness, dry mouth, fatigue, blurred vision [1.7.5].	General vertigo, motion sickness [1.4.5].
Diazepam	Benzodiazepine	Enhances GABA effects to suppress the central vestibular system [1.2.6].	Drowsiness, dependency, impaired coordination, memory problems [1.2.6, 1.3.2].	Acute, severe vertigo attacks (short-term) [1.3.2].
Prochlorperazine	Antiemetic (Phenothiazine)	Blocks dopamine receptors in the brain's chemoreceptor trigger zone [1.2.6].	Drowsiness, dizziness, extrapyramidal side effects (muscle spasms) [1.2.6].	Severe nausea and vomiting with vertigo [1.2.1].
Scopolamine	Anticholinergic	Blocks acetylcholine signals to control nausea and vestibular disturbances [1.2.6].	Dry mouth, drowsiness, blurred vision, confusion [1.7.1, 1.7.4].	Motion sickness, long-duration prevention (via patch) [1.7.5].

Over-the-Counter (OTC) and Natural Options

Some alternatives do not require a prescription.

OTC Antihistamines: Meclizine (Bonine, Dramamine Less Drowsy) and Dimenhydrinate (Dramamine Original) are effective first-line treatments for mild vertigo and motion sickness [1.4.3, 1.4.6].
Ginger: This root can be consumed as a tea or supplement and is known to help calm nausea associated with vertigo [1.4.1, 1.3.5].
Ginkgo Biloba: Some research suggests it may help by improving circulation, but evidence is mixed [1.3.5].

Non-Pharmacological Treatments: A Crucial Component

For many, especially those with BPPV, drug-free treatments are the most effective long-term solution.

Vestibular Rehabilitation Therapy (VRT)

VRT is a specialized form of physical therapy designed to retrain the brain to recognize and process signals from the vestibular system [1.5.1, 1.5.6]. An exercise-based program, it uses specific head, eye, and body movements to help the brain compensate for incorrect signals from the inner ear [1.5.4]. It is effective for a variety of balance disorders, including vestibular neuritis and Meniere's disease [1.5.3, 1.5.5].

Canalith Repositioning Procedures (CRP)

This is the primary treatment for Benign Paroxysmal Positional Vertigo (BPPV), which occurs when tiny calcium crystals (otoconia) become dislodged in the inner ear [1.6.1, 1.6.2]. The Epley Maneuver is the most common CRP, involving a series of specific head movements performed by a professional to guide these crystals back to a part of the ear where they no longer cause symptoms [1.6.2, 1.6.6]. This procedure is highly effective, relieving vertigo in about 80% of people after one or two treatments [1.6.1, 1.6.5].

Conclusion: Choosing the Right Alternative

The best alternative to betahistine depends entirely on the underlying cause of your vertigo. While medications like meclizine or diazepam can provide immediate relief from acute symptoms, non-pharmacological treatments like Vestibular Rehabilitation and the Epley Maneuver often offer a more permanent solution. It is crucial to consult a healthcare professional for an accurate diagnosis. They can rule out serious conditions and create a personalized treatment plan that may include medication, physical therapy, and lifestyle adjustments for the most effective management of your vertigo.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

For more information on vestibular disorders, you can visit the Vestibular Disorders Association (VeDA).

Frequently Asked Questions

There is no direct OTC equivalent to betahistine's mechanism of action. However, OTC antihistamines like meclizine (Bonine, Dramamine Less Drowsy) and dimenhydrinate (Dramamine) are commonly used to manage vertigo symptoms like dizziness and nausea [1.4.2, 1.4.3].

Meclizine is one of the most common medications used for vertigo in the U.S. It is available both over-the-counter for motion sickness and by prescription for vertigo [1.4.5].

The FDA withdrew its approval for betahistine in the 1970s, citing a lack of sufficient evidence from clinical trials to prove its effectiveness [1.9.1, 1.9.3]. While it's widely used in other countries, it is only available in the U.S. with a doctor's prescription from a compounding pharmacy [1.9.2].

Meclizine is an antihistamine that works by suppressing the vestibular system to reduce dizziness, and it can cause drowsiness [1.7.5]. Betahistine is a histamine analogue thought to improve microcirculation in the inner ear and is generally considered less sedating [1.2.1, 1.9.5].

A permanent cure depends on the cause. For Benign Paroxysmal Positional Vertigo (BPPV), the Epley maneuver can be a permanent fix, though recurrence is possible [1.6.1]. For chronic conditions like Meniere's disease, treatments focus on managing and reducing the frequency of symptoms rather than a complete cure [1.9.5].

The Epley maneuver, a type of canalith repositioning procedure, is highly effective for BPPV. It relieves vertigo symptoms in about 80% of individuals after just one or two treatment sessions [1.6.1, 1.6.5].

Yes, non-pharmacological treatments are very effective. Vestibular Rehabilitation Therapy (VRT) uses exercises to help your brain adapt to inner ear issues, and Canalith Repositioning Procedures like the Epley maneuver physically correct the cause of BPPV [1.5.1, 1.6.2].