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6 mg 12 mg 6 mg 12 mg
BPPV PCI
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DHI: Dizziness Handicap Inventory, DHI Score: 0-30 is mild, 31-60 is medium, 61-100 is severe, BPPV:
Benign Positional Paroxysmal Vertigo, PCI: Posterior Circulation Ischemia,
administered 1 month, n:60
Improves Quality of Life
Vertigo patient
1
pre
post
1. Graph adapted from Zi-ming W, et al. The effect of betahistine mesylate as a treatment to vertigo induced by inner ear ischemia. Chinese Scientific Journal of Hearing and Speech Rehabilitation 2007; 5: 26-29.
2. Japanese Package Insert, July 2009; 8th version
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3 7 14 30 60 90
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Days
LM: Liberatory Manoeuvre, BE: Betahistine mesylate, BPPV: Benign Positional Paroxysmal Vertigo.
32mg/day administered until complete recovery, n=52
Addition of Merislon provides
faster recovery of BPPV patients
1
LM
LM-BE
*
*
1. Cavaliere M, et al. Benign Paroxysmal Positional Vertigo: a study of two manoeuvres with and without betahistine. Acta Otorhinolaryngol Ital 25, 107-112, 2005.
2. Japanese Package Insert, July 2009; 8th version
*p<0.05
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1. Cavaliere M, et al. Benign Paroxysmal Positional Vertigo: a study of two manoeuvres with and without betahistine. Acta Otorhinolaryngol Ital 25, 107-112, 2005.
2. Japanese Package Insert, July 2009; 8th version
0
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3 7 14 30 60 90
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Days
BD: Brandt Daroff Exercises, BE: Betahistine mesylate, BPPV: Benign Positional Paroxysmal Vertigo,
32mg/day administered until complete recovery, n=51
Addition of provides
faster recovery of BPPV patient
1
BD
BD-BE
*
*
*p<0.05
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2.5
Before therapy 1 3 6 12
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Week
No Statistically significant difference between the therapy group
t.i.d has similar efficacy with
combination of two Anti vertigo drugs
1
Dimenhydrinate + Cinnarizine (n=40) Betahistine (n=40)
1. Adopted from Novotny, et al., Fixed combination of cinnarizine and dimenhydrinate versus betahistine dimesylate in the treatment of Menieres disease, International Tinnitus Journal, Vol.8, No.2: 115-123 (2002)
2. Japanese Package Insert, July 2009; 8th version
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5
99%
Total Adverse
Reaction :
26 patients
1%
Merislon is well tolerated
2
No Adverse Reaction Adverse Reaction
Total Patient:
2.254
1. Graph adapted from Zi-ming W, et al. The effect of betahistine mesylate as a treatment to vertigo induced by inner ear ischemia. Chinese Scientific Journal of Hearing and Speech Rehabilitation 2007; 5: 26-29.
2. Japanese Package Insert, July 2009; 8th version
Doses: 18mg 36mg /day
Common Adverse Reaction:
Nausea (0.44%), Skin Eruption (0.13%)
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Mesylate salt 5x more soluble, and 2.6x more
bioavailable than the hydrochloride salt
Mean plasma concentrations in male beagle
Engel GL, et al. Salt form selection and characterization of LY333531 mesylate monohydrate. International Journal of Pharmaceutics 198 (2000): 239-247
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1. Konfirmasi Vertigo ?
2. Tentukan Jenis
3. Tentukan Letak Lesi
4. Cari Kausa
5. Pilih Terapi :
Kausal
Simtomatik
Rehabilitasi
Vertigo Vestibular Vertigo Non Vestibular
Perifer Sentral Visual Somatosensorik
(Proprioseptif)
Al gor i t ma Ver t i go
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TERIMA KASIH
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