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Why are medicines important?
Medication is an important part of treating and controlling a wide range of symptoms linked to many different medical conditions. Almost half of all adults take prescription medication, most commonly to treat cholesterol, high blood pressure and pain. A quarter of these people report taking at least three prescribed medicines a week.
Did you know?
70 percent of people over 75 take three or more prescribed medicines a week.
Do medicines cause dizziness?
Yes. Dizziness accounts for 5 percent of all reported drug side effects. Dizziness, lightheadedness and imbalance are a side effect of many common drugs. This can cause problems because you are more likely to fall and hurt yourself. Falls are one of the biggest causes of injuries and many people end up in accident and emergency.
Some medicines can even make your balance system worse or prevent you recovering well from an acute episode of dizziness in conditions like labyrinthitis or vestibular neuritis. These medicines are called vestibular suppressants eg. Prochlorperazine, Betahistine, Amitriptyline, Cinnarizine, Cyclazine, Promethazine, Chlorpromazine, Diazepam, Midazolam etc. Some are beneficial treating an acute attack of dizziness but longer term can suppress your natural recovery and compensation processes.
You may also find you are taking medications for other conditions and those medications may effect your inner ear or balance system eg. antibiotics which are toxic to your inner ear and balance/ vestibular organ.
Did you know?
- The more medications you take, the more likely you are to fall.
- The longer you take medicines for dizziness (vestibular suppressants) after an acute episode the more likely you are to have longer term problems with dizziness and balance.
Top tips
- If you are over 70 and on three or more medications you should ask your doctor or community pharmacist for a medication review every six months
- Only take dizziness medication for as short a time possible (one to three days) before reviewing whether you need to continue taking it.
What medications cause dizziness?
Different medications work upon different systems in the body: They can act on: central (brain and nervous system); peripheral (inner ear, vision, sensory eg. touch, muscle and joint awareness); endocrine (hormones); cardiovascular systems (blood pressure, heart rate) etc.
If you take medications for conditions affecting these systems, the medicines that act on these systems can potentially cause dizziness. For example, blood pressure medications work by keeping your blood pressure lower and slow down the speed at which it changes. Therefore, if you get out of bed and stand quickly after lying down you may feel dizzy and light headed until your blood pressure adjusts to being stood up right.
If you take two or more blood pressure medications they can interact with each other to make the drop in blood pressure worse and may even cause you to faint or black out. It is important in situations like this that you report to your GP and tell them about any other symptoms you may experience eg. dizziness, palpitations, nausea, chest pain, shortness of breath etc.
Conditions causing dizziness
Common conditions causing dizziness can be found below.
Medicines with reported dizziness as a side effect
Commonly reported medications that cause dizziness can be found below
| Condition | Medications reported with side effect of dizziness |
|---|---|
| Blood pressure | Propranolol, Atenolol, Bisoprolol, Candesartan, Losartan, Irbesartan, Ramipril, Nicorandil, Amlodipine etc. |
| Epilepsy/ muscle relaxants | Phenytoin, Carbamazepine, Gabapentin, Pregabalin, Topiramate, Lamotrigine, Baclofen, Tizanidine, Cannabis extract, Dantrolene, Diazepam, etc. |
| Anxiety/ Depression | Fluoxetine, Trazodone, Sertraline, Citalopram, Mirtazapine, Paroxetine etc. |
| Cholesterol | Simvastatin, Atorvastatin etc. |
| Antibiotics | Ciprofloxacin, Amoxicillin, Azithromycin, Erythromycin, Vancomycin, Gentamicin etc. |
| Pain killers | Paracetamol, Codeine, Dihydracodeine, Co-codamol, Tramadol, Fentanyl, Ibuprofen, Naproxen, Diclofenac etc. |
Did you know?
- Taking medication for pain more than twice a week can cause headaches and dizziness as well as hyperalgesia (an increase in your pain, pain sensitivity, and rebound pain)
- The most common cause of peripheral dizziness or vertigo is BPPV, which does not resolve with medication
- One in seven patients attending the balance clinic present with dizziness as a side effect of their medication
- Recreational drugs eg. cannabis, cocaine, amphetamines, heroin, can also cause dizziness.
How do I know if medication is the cause of my dizziness?
An adverse drug reaction or side effect is defined as:
‘Any response to a drug which is noxious and unintended and that occurs at normal doses used in man for prophylaxis, diagnosis or therapy of disease or for modification of physiological function’
Taking a good medication history is important. Also, it’s essential to know about your drug tolerance, previous experience of a drug and drug allergies.
TREND is an acronym that helps find information about symptoms of dizziness and possible connections to the medications you are taking:
- Timing - Did symptoms start around the time of a new drug (eg. candesartan)? Are you taking a drug that causes side effects over time (eg. opioids / antiepileptics)?
- Re-challenge - If you take the drug again do the side effects occur?
- Experience - Have you had the drug before and did you experience any adverse reactions?
- Nature - Are the symptoms a recognised side effect of the drug you are considering is the problem?
- De-challenge - Do symptoms resolve when the medication is stopped?
If you are concerned about dizziness and think your medication may be involved please speak to your doctor, nurse or independent prescriber.
Top tips
- Do not stop taking medication without consulting your GP, nurse or independent prescriber
- It maybe possible to reduce the amount of medication you are on by making some simple changes to your diet and lifestyle. Your GP practice, physiotherapist or practice nurse can help develop a programme for you whilst monitoring the effects and advise on whether it is safe to stop any of your medications
- Making small changes can make a big difference.
Why not try:
- Brisk walking for 30 minutes every day in the daylight with moderate exertion and look around, moving your head, taking notice of the detail in the world around you
- Healthy eating, cut out processed foods and cook fresh
- Stay hydrated drinking two to three litres of fluid (not containing caffeine) daily
- Eat and sleep at the same time through the week
- Try something new like tai chi, adult ballet classes, yoga or bowling.
Our patients matter
Mersey Care NHS Foundation Trust listens and responds to patients and their carers to help improve the services we deliver.
If you have any comments,compliments or concerns you can speak with a member of staff or contact our Patient Advice and Liaison Service (PALS) and Complaints Team
Telephone: 0151 471 2377
Freephone: 0800 328 2941
Email: palsandcomplaints@merseycare.nhs.uk
To request this leaflet in an alternative format or language, please speak to a member of staff.Our patients matterMersey Care NHS Foundation Trust V7 Building, Kings Business Park, Prescot L34 1PJMay 2021
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