What are the recommended first-line treatments for managing symptoms in patients diagnosed with labyrinthitis?

Recommended first-line treatments for managing symptoms in patients diagnosed with labyrinthitis include:

• Consider prescribing a short course (up to 7 days) of prochlorperazine or an antihistamine such as cinnarizine, cyclizine, or promethazine teoclate to alleviate nausea, vomiting, and vertigo symptoms.
• If rapid relief is required for severe nausea or vomiting, buccal prochlorperazine or a deep intramuscular injection of prochlorperazine or cyclizine may be considered.
• Advise patients to take medication regularly for up to 3 days and to use the minimum amount of medication necessary, as prolonged use may delay recovery by affecting vestibular compensation.
• Benzodiazepines are not recommended due to lack of evidence, licensing, and potential for dependence.
• Hospital admission may be necessary if severe nausea and vomiting prevent oral intake and hydration.

Patients should be advised to return if symptoms deteriorate or do not improve after 5–7 days to reassess and exclude alternative diagnoses.

These recommendations are based on expert opinion and licensing for labyrinthine disorders, including labyrinthitis, and are consistent with management approaches for similar vestibular conditions.

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