Mitil contains prochlorperazine 5 mg, an anti-sickness medicine. It is used for nausea and vomiting, and particularly for vertigo and dizziness caused by inner-ear problems such as Ménière’s disease and labyrinthitis. It is a prescription medicine, and it can cause distinctive movement side effects.
What is Mitil?
Mitil is registered in South Africa as a Schedule 5 tablet containing prochlorperazine 5 mg — prescription-only.
Prochlorperazine is a phenothiazine and works mainly by blocking dopamine D2 receptors in the chemoreceptor trigger zone — the area of the brainstem that detects circulating substances and triggers vomiting. Blocking it suppresses the vomiting signal.
Its usefulness in vertigo comes from a second action. Prochlorperazine also acts on the vestibular system, the balance apparatus of the inner ear and its connections in the brain, damping down the abnormal signals that produce the spinning sensation. That makes it one of the more commonly used medicines for vertigo — a role most anti-sickness medicines do not have.
Blocking dopamine is also the source of its main risk. Dopamine is central to controlling movement, so blocking it can cause involuntary muscle and movement problems, described below. These are more likely in young people and with higher doses.
Prochlorperazine is chemically related to antipsychotic medicines, and at much higher doses it has been used that way — but at 5 mg it is being used for nausea and vertigo, not for a psychiatric condition. If you have been prescribed it, that is almost certainly why.
What is Mitil commonly used for?
- Vertigo and dizziness from inner-ear causes — Ménière’s disease, labyrinthitis and vestibular neuritis. A principal use.
- Nausea and vomiting from many causes, including medicines, migraine and post-operative sickness.
- Nausea associated with vertigo, where one medicine addresses both.
- Migraine, for the nausea and vomiting that accompany attacks.
- Motion sickness, in some cases.
- Nausea in palliative care, or from chemotherapy.
It treats the symptom, not the cause. Vertigo has many possible causes, and the right long-term approach depends on which one — some respond to specific repositioning manoeuvres rather than medicine at all.
For benign paroxysmal positional vertigo (BPPV) — brief spinning triggered by head movements such as rolling over in bed or looking up — medicine is generally not the answer. BPPV is caused by displaced crystals in the inner ear, and is usually treated very effectively with a physical repositioning manoeuvre performed by a trained clinician. If your vertigo comes in short bursts triggered by position changes, ask about this.
Prolonged use in vertigo can hinder recovery. The brain compensates for a damaged balance organ over time, and suppressing the signals continuously can slow that adaptation. Courses are usually kept short for this reason.
How Mitil fits into this medicine category
| Group | Examples | Role |
|---|---|---|
| Phenothiazine anti-emetics | Prochlorperazine (Mitil) | Nausea, vomiting, vertigo |
| Dopamine antagonists (prokinetic) | Metoclopramide | Nausea plus faster stomach emptying |
| Antihistamine anti-emetics | Cyclizine, promethazine | Motion sickness, vertigo, general nausea |
| 5-HT3 antagonists | Ondansetron | Chemotherapy and post-operative nausea |
| Antispasmodics | Hyoscine | Gut cramping; also motion sickness |
| Vestibular rehabilitation | Exercises, repositioning manoeuvres | Often more effective than medicine long term |
See the digestive and stomach medicines hub.
What to check before using Mitil
Do not drive or operate machinery until you know how it affects you. Drowsiness is common, and vertigo itself already impairs safe driving.
Tell your doctor or pharmacist if you:
- Are under 20, or a child. Young people are considerably more likely to develop acute movement reactions, and prochlorperazine is generally avoided in children.
- Are elderly, where sedation, confusion, falls and longer-term movement disorders are more likely.
- Have Parkinson’s disease or Lewy body dementia — prochlorperazine blocks dopamine and can markedly worsen these. Generally avoided.
- Have epilepsy.
- Have liver or kidney disease.
- Have heart rhythm problems, or take medicines affecting the QT interval.
- Have low blood pressure, or faint easily.
- Have glaucoma, or prostate enlargement.
- Have dementia.
- Are pregnant or breastfeeding.
- Take any other sedating medicine, antipsychotics, metoclopramide — the movement risks add up — or alcohol.
Stand up slowly, as prochlorperazine can lower blood pressure.
Possible cautions and when to ask a pharmacist or doctor
Common effects are drowsiness, dizziness, dry mouth, blurred vision, low blood pressure on standing, and restlessness.
Stop and seek medical attention urgently if you develop:
- Uncontrolled muscle spasms, particularly of the face, neck, jaw, tongue or eyes — including the head or neck twisting to one side, the eyes rolling upward, or difficulty speaking or swallowing. These acute dystonic reactions usually appear within the first days, are much more common in young people, and are frightening but treatable. Go to an emergency department, as they respond well to treatment.
- An inability to sit still, with intense inner restlessness (akathisia).
- Tremor, muscle stiffness, slowed movement or a shuffling walk.
- Repetitive involuntary movements of the face, tongue or lips. Tardive dyskinesia can be permanent, is more likely with prolonged use and in older people, and must be reported immediately.
- High fever with muscle stiffness, confusion, sweating and a fast pulse — a rare emergency.
- A seizure.
- Fainting, or a fast or irregular heartbeat.
- Yellowing of the eyes or skin.
- Fever, sore throat or mouth ulcers, which may indicate a blood problem.
- Swelling of the face, lips or tongue, or a severe rash.
Knowing what these movement reactions look like matters, because they are easily mistaken for something else — particularly in a young person, where a dystonic reaction can be misread as a seizure or a psychiatric episode.
See a doctor rather than continuing if:
- Vertigo is not improving, or you need the medicine for more than a short course.
- Vertigo comes with hearing loss, ringing in the ears, or ear discharge.
- Vertigo comes with double vision, slurred speech, weakness, numbness, severe headache or difficulty walking — seek emergency care, as these can indicate a stroke rather than an inner-ear problem.
- Vertigo comes in short bursts triggered by head position, which suggests BPPV and a repositioning manoeuvre.
- Vomiting persists, or you cannot keep fluids down.
- You have severe abdominal pain, or are vomiting blood.
Related medicine guides
Frequently asked questions
What are Mitil tablets used for? Nausea and vomiting, and particularly vertigo and dizziness from inner-ear conditions such as Ménière’s disease and labyrinthitis. Each tablet contains prochlorperazine 5 mg.
What is Mitil 5 mg used for? The same purposes — 5 mg is the standard tablet strength for nausea and vertigo.
Is Mitil an antipsychotic? Prochlorperazine is chemically related to antipsychotics and has been used that way at much higher doses. At 5 mg it is being used for nausea and vertigo.
Does it make you drowsy? Commonly, yes. Do not drive or operate machinery until you know how it affects you.
How long can I take it? Usually a short course. Prolonged use in vertigo can slow the brain’s natural compensation, so it is not intended as ongoing treatment.
What are the movement side effects? Muscle spasms of the face, neck or eyes, inner restlessness, tremor and stiffness, or repetitive mouth movements. Seek urgent medical attention if any occur.
Can children take it? It is generally avoided in children and young people, who are much more likely to get acute movement reactions.
When is vertigo an emergency? If it comes with double vision, slurred speech, weakness, numbness, severe headache or difficulty walking — these can indicate a stroke.