JOHN LI, M.D.
OTOLOGY NEUROTOLOGY RESOURCES
210 Jupiter Lakes Blvd #5105
Jupiter, FL 33458
Medical Treatment of Meniere's Syndrome or Endolymphatic Hydrops
The goal of medications are to mask the vertigo and/or decrease the fluid pressure load in the inner ear.
We usually start with a dietary protocol which involves reduction of: Salt, caffeine, chocolate, red wine and refined sugars, artificial or otherwise.
Next, we will move onto medications. In an acute attack, we use medications that dull the sensation of vertigo using:
|Antivert: 1 tablet every 8 hours or as needed.|
|Droperidol: 1-2 drops under the tongue during severe attacks.|
If the patient has nausea or vomiting we can try antiemetics
|Compazine: 10 mg orally or rectal suppository for nausea (use when too sick for pills).|
|Phernagan: 25 mg orally or by rectal suppository|
Caution: Do not drive or operate heavy machinery while dizzy or taking above medication as they may impair your judgement and reflexes.
Prevention of attacks may be achieved by reducing inner ear pressure. This can sometimes be done using diuretics, aka "water pills".
|Dyazide: 1 “water pill” a day in the mornings. (decreases the fluid pressure load)|
|Neptazane: reduces fluid pressure in the CSF give as 50-100 mg 3 times a day.|
Caution: Do not take Dyazide or other water pills if you have low blood pressure or are already taking antihypertensive medication. If in doubt, ask your family physician.
Steroids can be used to reduce inner ear inflammation and settle down hydrops in acute situations. It can be dramatically effective for the immediate problem. However, due to side-effects, we do not use it long term.
|Medrol Dose pack: take as directed, 6 tabs day 1, 5 tabs day 2 until the pack is gone.|
|Prednisone: 10 mg tablets in an as directed manner.|
|Dexamethasone: 4 mg daily for 2 weeks, then .75 mg every other day for 1 month.|
Caution: Steroids can have, but are not limited to the following side effects: GI upset, gastritis, ulcers (take with meals) insomnia and irritability and mood changes. Prolonged use may cause weight gain, rounded face, body changes, adrenal suppression and possible hip problems.
Copyright © 2013 John Li M.D. All Rights Reserved