For acute severe peripheral vertigo, a commonly used drug is prochlorperazine, particularly when nausea and vomiting are prominent.

Other short-term vestibular suppressants include meclizine or cinnarizine. Use only briefly, usually 1-3 days, because longer use can delay vestibular compensation.

Do not treat presumed BPPV mainly with medicines: the Epley repositioning manoeuvre is preferred. Sudden vertigo with new weakness, severe headache, speech problems, inability to walk, or hearing loss needs urgent assessment for a central cause such as stroke.