Efficacy and Safety of a Fixed Combination of Cinnarizine 20 mg and Dimenhydrinate 40 mg vs Betahistine Dihydrochloride 16 mg -NCBI 2019 Sep 30



Vertigo derived from peripheral vestibular disorders is quite frequently encountered in daily clinical practice and can be a severely disabling symptom associated with substantial impairment of health-related quality of life for the affected patients. Betahistine, a structural analogue of histamine and presumably the most widely prescribed anti-vertigo drug worldwide, has previously been shown to be an effective and safe treatment for these patients. The objective of the present study was to evaluate whether the fixed combination of cinnarizine and dimenhydrinate (Arlevert®) is non-inferior and thus a potentially useful alternative to betahistine dihydrochloride in the treatment of patients suffering from peripheral vestibular vertigo.


The fixed combination of cinnarizine 20 mg and dimenhydrinate 40 mg was found to be not only non-inferior, but superior to betahistine 16 mg in the improvement of peripheral vestibular vertigo. Furthermore, taking into account a good and slightly favorable safety profile, the present study provides evidence that the fixed-combination preparation is a potent and even superior alternative to betahistine in the treatment of vertigo related to peripheral vestibular disorders.


At this time Cinnarizine is not available in the United States or Canada. It is available just about everywhere else in the world. At the same time Dimenhydrinate is not available in the United Kingdom, but is available in the United States. -Daniel Pancy

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. -2019 Sep 30.

Scholtz AW1Hahn A2Stefflova B3Medzhidieva D4Ryazantsev SV5Paschinin A6Kunelskaya N7Schumacher K8Weisshaar G9.

Author information

1ENT Clinic, Medical University of Innsbruck, and ENT Center for Vertigo, Innsbruck, Austria.2ENT Clinic, 3rd Medical Faculty, Charles University of Prague, Prague, Czech Republic.3ENT Clinic, Regional Hospital Budweis, Budweis, Czech Republic.4ENT Clinic, Medical University of Sofia-St. Ivan Rilski Hospital, Sofia, Bulgaria.5Federal State Institution St. Petersburg Research Institute of Ear, Throat, Nose and Speech, St. Petersburg, Russia.6North West State Medical University n. a. I.I. Mechnikov of Ministry of Health and Social Development, St. Petersburg, Russia.7Moscow Research-Practical Center of Otolaryngology n. a. L. I. Sverzhevsky, Moscow, Russia.8Berlin-Chemie AG/Menarini, Berlin, Germany.9Hennig Arzneimittel, Flörsheim am Main, Germany. gerhard.weisshaar@hennig-am.de.

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