Several medicines can cause dizziness or a spinning feeling called vertigo. Common examples include some blood pressure medicines, antidepressants, anti-seizure drugs, sedatives, and tranquilizers. Certain antibiotics and chemotherapy medicines can affect the inner ear and balance. The risk depends on the medicine, dose, other medicines, and health conditions. Do not stop a prescribed drug on your own; a doctor or pharmacist can review symptoms and safer options.
Which medicines can cause dizziness or vertigo?
Dizziness can mean feeling faint, lightheaded, or unsteady. Vertigo is the feeling that you or your surroundings are spinning when nothing is moving. Medicines may cause these sensations by lowering blood pressure, affecting the brain's balance and alertness systems, or damaging parts of the inner ear. According to the Mayo Clinic, several commonly used medication groups are associated with dizziness, although not everyone who takes them experiences this side effect.
- Blood pressure medicines: Some medicines that lower blood pressure can cause lightheadedness, particularly when blood pressure falls too much. The effect may be noticeable when standing up.
- Antidepressants: Certain antidepressants can cause dizziness, sometimes because they lower blood pressure. The likelihood varies by medication.
- Anti-seizure medicines: These medicines can cause dizziness or affect balance in some people.
- Sedatives and tranquilizers: Medicines used to calm anxiety or promote relaxation can affect alertness and coordination, potentially contributing to an unsteady feeling.
- Antihistamines: Some allergy medicines, especially those that cause drowsiness, can produce dizziness or impaired coordination.
- Sleeping pills, opioids, and muscle relaxants: These medicines can affect alertness, reaction time, or coordination, making some activities less safe.
- Certain antibiotics and chemotherapy medicines: Some can affect the inner ear, which helps control balance, and may cause vertigo or difficulty walking steadily.
Can over-the-counter medicines also cause dizziness?
Yes. Prescription medicines are not the only possible cause. Over-the-counter products used for allergies, colds, coughs, and motion sickness can contain ingredients that cause dizziness or drowsiness. Some nighttime cold remedies also contain sedating antihistamines. The U.S. Food and Drug Administration (FDA) notes that medication side effects can include dizziness, blurred vision, sleepiness, and slowed or uncoordinated movement. These effects can interfere with driving or other activities that require concentration.
Check the active ingredients on combination cold and allergy products, particularly if you already take prescription medicines. Two products may contain the same ingredient, or their effects may overlap. A pharmacist can help you check for possible interactions and identify an appropriate alternative when needed.
How do different medicines cause dizziness?
Blood pressure changes
Some medicines lower blood pressure enough to cause lightheadedness. This may happen when you move from sitting or lying down to standing, especially if your body does not adjust quickly enough. You might feel faint, weak, or unsteady rather than experience a spinning sensation. A clinician may consider your blood pressure, medication schedule, and symptoms when assessing whether a medicine could be contributing.
Effects on the brain and balance
Medicines that cause drowsiness or affect the central nervous system can interfere with alertness and coordination. This may feel like general unsteadiness rather than true vertigo. The effect depends on the medicine, and combinations of medicines can make impairment more noticeable. Alcohol may also increase drowsiness or other unwanted effects with certain medicines.
Effects on the inner ear
Some medicines can damage the inner ear structures involved in hearing and balance. The Merck Manual Consumer Version describes this as ototoxicity. Examples include certain antibiotics, such as gentamicin, tobramycin, and streptomycin; some chemotherapy medicines, such as cisplatin; and certain other drugs, including furosemide and aspirin. Depending on the medicine and circumstances, symptoms may include vertigo, difficulty maintaining balance, ringing in the ears, or hearing loss. The risk varies with factors such as dose, duration of treatment, kidney function, and use of more than one medicine with ototoxic potential.
Blood pressure effects of antidepressants
Dizziness is more common with some types of antidepressants than with others. According to the Mayo Clinic's guidance on antidepressant side effects, tricyclic antidepressants and monoamine oxidase inhibitors (MAOIs) are more likely to cause dizziness than other antidepressants, and these medicines can lower blood pressure. This does not mean everyone taking an antidepressant will experience dizziness. The specific medicine and a person's response matter when deciding whether a change is appropriate.
When is dizziness more likely to be related to a medicine?
A medication side effect may be considered when dizziness begins after a new medicine is started, a dose is increased, or another medicine is added. However, symptoms can also develop while someone has been taking a medicine for some time, and their timing alone cannot establish the cause. Dehydration, blood pressure changes, inner ear conditions, and other health problems can produce similar sensations.
Older adults may be more vulnerable to medication-related dizziness and balance problems, especially when they take several medicines. Age-related changes in balance and other health conditions may also contribute. The National Library of Medicine's MedlinePlus guidance on dizziness and vertigo notes that these symptoms become more common with age and that healthcare professionals consider a person's medicines, symptoms, and examination when assessing possible causes. Dizziness can increase the risk of falls, so new balance problems deserve attention.
What should you do if a medicine makes you dizzy?
If dizziness starts after you take a medicine, contact your prescribing clinician or pharmacist, particularly if the symptoms recur, persist, worsen, or interfere with everyday activities. Do not stop, reduce, or change a prescribed medicine without professional guidance. Some medicines need careful adjustment, and suddenly stopping certain treatments can cause problems. A clinician may review the dose, timing, possible interactions, or need for an alternative based on the medicine and your medical history.
Before speaking with a healthcare professional, make a list of your prescription medicines, over-the-counter products, and supplements. Note when the dizziness started, when you take each medicine, how long the symptoms last, and whether you feel faint, unsteady, or as though the surroundings are spinning. Also mention any ringing in the ears, hearing changes, nausea, or recent falls. These details can help guide the medication review.
While dizzy, sit or lie down until you feel steadier, and rise slowly. Avoid driving, operating machinery, climbing, or other activities in which a sudden loss of balance could cause injury. Do not assume that a medicine is safe for these activities just because it is available without a prescription; check its warnings and ask a pharmacist or clinician when uncertain.
When does dizziness need urgent medical attention?
Do not assume that sudden or unusual dizziness is a medication side effect. Seek emergency medical care if dizziness or vertigo occurs with warning signs such as:
- Sudden weakness, numbness, or difficulty moving an arm or leg.
- Slurred speech, confusion, or sudden changes in vision.
- Chest pain, difficulty breathing, or a rapid or irregular heartbeat.
- Fainting, a sudden severe headache, or difficulty walking.
- Severe or persistent vomiting, particularly with other concerning symptoms.
New hearing loss or dizziness that begins after taking a medicine also warrants prompt medical assessment. If symptoms are persistent, worsening, unusual for you, or disruptive to daily activities, arrange a medical review even when no emergency warning signs are present.