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Betahistine (United States: Not available): Drug information

Betahistine (United States: Not available): Drug information
(For additional information see "Betahistine (United States: Not available): Patient drug information")

For abbreviations, symbols, and age group definitions used in Lexicomp (show table)
Brand Names: Canada
  • Auro-Betahistine;
  • M-Betahistine;
  • MINT-Betahistine;
  • PMS-Betahistine;
  • Serc;
  • TEVA-Betahistine
Pharmacologic Category
  • Histamine H1 Agonist;
  • Histamine H3 Antagonist
Dosing: Adult
Meniere disease, chronic management

Meniere disease, chronic management:

Note: Reserve pharmacotherapy for patients in whom lifestyle modifications do not result in sufficient response. Provide as-needed vestibular suppressants and antiemetics for acute relief of vertigo (Ref).

Oral: Initial: 24 to 48 mg/day in 2 to 3 divided doses (Ref). Some experts initiate at a lower dose (eg, 8 to 16 mg once daily) and increase at 2- to 4-week intervals as needed to twice daily, then 3 times daily based on response and tolerability (Ref). May taper and discontinue after 3 to 6 months of prolonged control (Ref).

Dosing: Kidney Impairment: Adult

The renal dosing recommendations are based upon the best available evidence and clinical expertise. Senior Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.

Altered kidney function: No dosage adjustment likely to be necessary for any degree of kidney dysfunction (undergoes rapid and extensive first pass metabolism to an inactive metabolite (Ref)) (Ref).

Hemodialysis, intermittent (thrice weekly): Unlikely to be significantly dialyzed (rapidly converted to inactive metabolite): No supplemental dose or dosage adjustment necessary; when scheduled dose falls on a dialysis day, administer after administer after dialysis as a precaution since there are no data (Ref).

Peritoneal dialysis: Unlikely to be significantly dialyzed (rapidly converted to inactive metabolite): No dosage adjustment necessary (Ref).

CRRT: No dosage adjustment likely to be necessary (Ref).

PIRRT (eg, sustained, low-efficiency diafiltration): No dosage adjustment likely to be necessary (Ref).

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Betahistine primarily undergoes hepatic metabolism; use with caution.

Dosing: Older Adult

Refer to adult dosing.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

1% to 10%:

Central nervous system: Headache (5%)

Gastrointestinal: Nausea (2%), dyspepsia

Frequency not defined:

Central nervous system: Confusion, convulsions, drowsiness (case reports), hallucination, paraesthesia

Cardiovascular: Hypotension (including orthostatic and postural hypotension), tachycardia, ventricular premature contractions (case reports)

Dermatologic: Pruritus, skin rash, Stevens-Johnson syndrome, urticaria

Gastrointestinal: Abdominal distension, abdominal pain, bloating, peptic ulcer (including exacerbation of previous disease), vomiting

Hypersensitivity: Anaphylaxis, angioedema, hypersensitivity reaction

Respiratory: Dyspnea

Contraindications

Hypersensitivity to betahistine or any component of the formulation; presence or history of active peptic ulcer disease; pheochromocytoma

Warnings/Precautions

Disease-related concerns:

• Asthma: Use with caution; clinical intolerance has been reported in a few asthmatic patients.

• Cardiovascular disease: Use with caution in patients with cardiovascular disease; post-market cases of ventricular extrasystoles, hypotension, and tachycardia have been reported during use.

• Hepatic impairment: Use with caution; primarily undergoes hepatic metabolism.

• Peptic ulcer: Exacerbation of symptoms has been observed in patients with a history of peptic ulcer; use is contraindicated in the presence or history of peptic ulcer.

Product Availability

Not available in the US

Generic Equivalent Available: US

May be product dependent

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Tablet, Oral, as hydrochloride:

Serc: 16 mg, 24 mg

Generic: 8 mg, 16 mg, 24 mg

Administration: Adult

Oral: Administer with or without meals; administer with meals if adverse GI effects occur.

Use: Labeled Indications

Note: Not approved in the United States.

Meniere disease: Treatment of Meniere disease (to decrease episodes of vertigo).

Metabolism/Transport Effects

None known.

Drug Interactions

Note: Interacting drugs may not be individually listed below if they are part of a group interaction (eg, individual drugs within “CYP3A4 Inducers [Strong]” are NOT listed). For a complete list of drug interactions by individual drug name and detailed management recommendations, use the Lexicomp drug interactions program by clicking on the “Launch drug interactions program” link above.

Antihistamines: May diminish the therapeutic effect of Betahistine. Betahistine may diminish the therapeutic effect of Antihistamines. Risk C: Monitor therapy

Monoamine Oxidase Inhibitors: May increase the serum concentration of Betahistine. Risk C: Monitor therapy

Pregnancy Considerations

Adverse events were observed in some animal reproduction studies.

Breastfeeding Considerations

It is not known if betahistine is present in breast milk. According to the manufacturer, the decision to continue or discontinue breastfeeding during therapy should take into account the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.

Mechanism of Action

Partial agonist of histamine at H1 receptor and antagonist at H3 receptor; relatively inactive at H2 receptor. Animal studies suggest that betahistine may increase cochlear blood flow and produce excitatory effects on neuronal activity of cortical and subcortical structures via H1-receptor agonism and decrease vestibular sensory input and increase synthesis and release of histamine from the hypothalamus via H3-receptor antagonism (Ihler 2012; Lacour 2007).

Pharmacokinetics (Adult Data Unless Noted)

Absorption: Rapid, complete; delayed by food

Tmax: 1 hour to reach peak levels of inactive metabolite

Protein binding: <5%

Metabolism: Rapid and almost complete hepatic metabolism to 2-pyridylacetic acid (inactive metabolite)

Half-life elimination: ~3.5 hours (inactive metabolite)

Excretion: Urine (~91%; primarily as inactive metabolite)

Brand Names: International
International Brand Names by Country
For country code abbreviations (show table)

  • (AE) United Arab Emirates: Betaquil | Betaserc | Histabentine | Lavistina | Merislon | Mevetin | Vertin | Virtigene;
  • (AR) Argentina: Audipax | Audipax multidosis | Betahistina richet | Betaserc | Betina | Meniex | Microser | Microser forte | Otevil | Ronistina | Tiveg | Travelmin;
  • (AT) Austria: Betahistin | Betahistin Arcana | Betaserc;
  • (AU) Australia: Apo betahistine | Betahistine an | Betahistine generichealth | Betahistine mylan | Betahistine sandoz | Betasert | Seniere | Serc | Setear;
  • (BD) Bangladesh: Menaril | Merislon | Tiniril | Vectra | Veserc;
  • (BE) Belgium: Betahistine eurogenerics | Betahistine ips | Betahistine merck-generics | Betahistine sandoz | Betahistine teva generics belgium | Betahistop | Betaserc | Docbetahi | Lobione;
  • (BF) Burkina Faso: Betaserc;
  • (BG) Bulgaria: Alvobehist | Betahistine aurobindo | Betaserc | Betastad | Emperin | Microser | Tevabehist | Vertimed | Vertisan | Vestibo;
  • (BR) Brazil: Betadine | Betadine xr | Betaserc | Betina | Debet | Dicloridrato de betaistina | Labirin | Ucibeta;
  • (CH) Switzerland: Betahistin Actavis | Betahistin Mepha | Betahistin spirig hc | Betaserc;
  • (CI) Côte d'Ivoire: Betaserc | Serc;
  • (CL) Chile: Betaserc | Betina | Microser | Vasomotal;
  • (CN) China: Betahistine | Merislon | Microser | Min shi lang | Pu lai;
  • (CO) Colombia: Betahistina | Betahistina Clorhidrato | Betahistina diclorhidrato | Betahistina winthrop | Betaserc | Bolaria | Garmisch leflux | Histivert | Leflux | Vaio | Vertibistin | Vertigen | Vertipro | Vertix | Verum | Visep;
  • (CZ) Czech Republic: Avertin | Betahirex | Betahistin accord | Betahistin aurobindo | Betahistin Mylan | Betahistin ratiopharm | Betaserc | Emperin | Microser | Vertibetis | Vertimed | Zenostig;
  • (DE) Germany: Aequamen | Betahistin | Betahistin Ratiopharm | Betaserc | Betavert | Betavert N | Melopat | Vasomotal;
  • (DK) Denmark: Betaserc;
  • (DO) Dominican Republic: Audipax multidosis | Betaserc | Betistin | Bolaria | Fidium | Merinen | Merislon | Novirex | Valnesio | Vertix | Zevert;
  • (EC) Ecuador: Audipax multidosis | Betahistina | Betaserc | Microser | Vertibistin;
  • (EE) Estonia: Betahistine accord | Betaserc | Vertimed;
  • (EG) Egypt: Balanserc | Betaserc | Betasine | Histaseric | Histine | Histotec | Mepahist | Microserc | Steadyfutal | Verserc | Vertiserc;
  • (ES) Spain: Betahistidina | Betahistina aurobindo | Betahistina bluefish | Betahistina Cinfa | Betahistina combix | Betahistina Kern Pharma | Betahistina normon | Betahistina qualigen | Betahistina sandoz | Betahistina Stada | Betahistina tecnigen | Fidium | Serc;
  • (ET) Ethiopia: Be stedy;
  • (FI) Finland: Betahistin Alternova | Betahistin orifarm | Betahistin ratiopharm | Betahistine accord | Betahistine stada | Betaserc;
  • (FR) France: Betahistine | Betahistine accord | Betahistine actavis | Betahistine Almus | Betahistine arrow | Betahistine biogaran | Betahistine Biphar | Betahistine Bouchara | Betahistine cristers | Betahistine g gam | Betahistine gnr | Betahistine irex | Betahistine ivax | Betahistine merck | Betahistine mylan pharma | Betahistine Qualimed | Betahistine Ranbaxy | Betahistine Ratiopharm | Betahistine rpg | Betahistine sandoz | Betahistine teva | Betahistine zydus | Betaserc | Evolis | Lectil | Serc | Vertigirex;
  • (GB) United Kingdom: Betahistine | Betahistine arrow | Betahistine cox | Betahistine kent | Betahistine sandoz | Serc;
  • (GR) Greece: Antivom | Betaserc | Katabexin | Ribrain | Riva | Stimobral;
  • (HK) Hong Kong: Alfinor | Antivom | Behistin | Beta-Synto | Betaserc | Bymeniere | Deanosart | Meniace | Meniero | Menitazine | Merislon | Merison | Serc | Tenyl;
  • (HR) Croatia: Betahistin PharmaS | Betaserc | Urutal;
  • (HU) Hungary: Betahistin Pliva | Betahistin ratiopharm | Betarevin | Betaserc | Elven | Emperin | Microser | Polvertic | Zenostig;
  • (ID) Indonesia: Betahistine | Betaserc | Darvon | Histigo | Kurtigo | Lexigo | Merislon | Mertigo | Noverty | Rotaver | Vastigo | Vercure | Versilon | Vertex | Vertigosan | Vesitab;
  • (IE) Ireland: Betahistine | Betahistine dihydrochloride | By vertin | Serc | Vertigon;
  • (IL) Israel: Agiserc | Betistine;
  • (IN) India: Acovert | Aver | B hist | B stil | Balanse | Bell histine | Berzin | Betacent | Betaford | Betagold | Betahans | Betahart | Betahist | Betavert | Betazox | Betleods | BHT | Biovert | Bvert | Divert | Dizibeat | Egeptin | Egeptin od | Estanox | Estanox od | Gidihist | Gospin | Hist | Histavert | Histidiz | Meni | Merislon | Ms beta | Mvert | Neuvert | No dizz | Nurohist | Osmohist | Ronyvert | Sovert | Staverti | Univert | Verbet | Verik | Vernil | Vertag | Vertibil | Vertibus | Vertic | Vertidin 16 | Vertidin 24 | Vertidin 8 | Vertiford | Vertihist | Vertin | Vertipress | Vertirest | Vertirest od | Vertiset 16 | Vertistar | Vertistop | Vertohist | Vertol | Verzin | Vesbal | Vetahist | Wertilin sr | Zevert | Zevert od;
  • (IT) Italy: Betaistina | Betaistina accord | Betaistina Actavis | Betaistina Angenerico | Betaistina aurobindo | Betaistina Doc | Betaistina EG | Betaistina Mylan | Betaistina tecnigen | Betaistina teva | Betigo | Jarapp | Microser | Sincrover | Vertiserc;
  • (JO) Jordan: Betaserc | Betastin | Merislon | Vasoserc | Vasoserc bid | Verotec;
  • (JP) Japan: Betahistine mesilate teva | Betatoludin | Convermin | Convermin m | Daishin b | Deanosart | Ectas | Ectas showa | Hynimeru | Medan | Meginalisk | Meginalon s | Melbestin | Mellite | Meniace | Meniesuchin | Meniesuchin choseido | Menietol | Menitazine | Meotels | Merislon | Metahislon | Metroneana | Mitapop | Papaverian | Pyritylulon | Remark | Riptonin | Suzutolon | Tenyl;
  • (KE) Kenya: Besdiz | Betaserc;
  • (KR) Korea, Republic of: Antivoice | Bertine | Beta q | Betahis | Betamer | Betine | Betione | Hislim | Megabeta | Menecin | Menes s | Meniace | Meniace s | Metastine | Nalsinin forte | U turn;
  • (KW) Kuwait: Anatax | Betagen | Betaserc | Lavistina;
  • (LB) Lebanon: Alvigo | Betahistine arrow | Betaserc | Vasoserc | Vasoserc bid | Vertinex;
  • (LT) Lithuania: Aequamen | Betahistin Actavis | Betahistine accord | Betahistine actavis | Betahistine ingen pharma | Betaserc | Microser | Polvertic | Vertimed;
  • (LU) Luxembourg: Betaserc | Docbetahi | Lectil;
  • (LV) Latvia: Betahistin Actavis | Betahistine accord | Betaserc | Polvertic | Vertimed;
  • (MA) Morocco: Betaserc | Lectil | Serc | Vertis;
  • (MX) Mexico: Adenex | Beena | Betahistina | Bitenver | Gidzy | Ingralor | Safinos | Serc | Vahitra | Vistrol;
  • (MY) Malaysia: Betahist | Betanor | Betaserc | Menitazine | Merislon | Stei | Verhistine;
  • (NL) Netherlands: Betahistine 2 HCl Accord | Betahistine 2 hcl flx | Betahistine 2hcl | Betahistine 2hcl A | Betahistine 2hcl gf | Betahistine 2hcl PCH | Betahistine 2hcl Ratiopharm | Betahistine dihcl | Betahistine dihcl 16 mg teva | Betahistine Dihcl Katwijk | Betahistine dihcl merck | Betahistine.2hcl Sandoz | Betalose | Betaserc | Serc;
  • (NZ) New Zealand: Serc | Vergo;
  • (PE) Peru: Betahistina diclorhidrato | Betamark | Betaserc | Betaver | Betina | Bolaria | Hisbec | Menistin | Microser | Verhistine | Vertiner;
  • (PH) Philippines: Bestine | Betatristin | Betavert | Dizzex | Ergo | Exigo | Gohistine | Normini | Nuvert | O vert | Reduhist | Serc | Verbeta | Verdiz | Verist | Vert | Vertegra | Vertiduce | Vertikind | Vertilate | Vertrol | Vibert | Vomivert | Zystine;
  • (PK) Pakistan: Aequamen | Bartex | Betahist | Betalin | Betanex | Betaride | Betazak | Betsan | D vert | Deperin | Enier | Gerohist | Hibet forte | Histogen | Kert | Microser | Nozavra | Nozavra d | Scitin | Serc | Stabler | Tigo | Varsilla | Vergo | Verteg | Vertex | Vertimin | Vetinil | Zertigo;
  • (PL) Poland: Apobetina | Behistep | Betahistine dihydrochloride accord | Betahistine Pliva | Betahistyna Bluefish | Betanil Forte | Betaserc | Emperin | Histigen | Histimerck | Lavistina | Microser | Neatin | Polvertic | Serc | Verhist | Vertigen | Vertisan | Vertix | Vestibo | Virtago | Zenostig;
  • (PT) Portugal: Beta histina Farmoz | Beta histina labesfal | Beta histina Pentafarma | Beta histina pharmakern | Betahistina | Betahistina Actavis | Betahistina bluepharma | Betahistina ciclum | Betahistina Germed | Betaserc;
  • (PY) Paraguay: Aclyr | Betahistina celsius | Betahistina prosalud | Betina | Bolaria | Dihidrocloruro de betahistina bp eposino | Meniex | Novertin | Vasomotal | Vertirex;
  • (QA) Qatar: Anatax | Be-Stedy | Betagen | Betaserc | Histabentine | Misoserc | Verotec;
  • (RO) Romania: Betahistina atb | Betahistina diclorhidrat aurobindo | Betahistina lph | Betaserc | Betastin | Diclorhidrat de betahistina accord | Emperin | Urutal | Vertimed | Vestibo;
  • (RU) Russian Federation: Asniton | Betacentrine | Betahistin | Betahistin nanolek | Betahistine | Betahistine akrikhin | Betahistine dihydrochloride | Betahistine medisorb | Betaserc | Betaserc long | Betaver | Denoize | Microser | Tagista | Vasoserc | Vertran | Vestibo | Vestinorm;
  • (SA) Saudi Arabia: Betagen | Betaserc | Betavert | Lavistina | Merislon;
  • (SE) Sweden: Betahistin 2care4 | Betahistin abacus medicine | Betahistin ebb | Betahistine stada | Betavert | Vertisan;
  • (SG) Singapore: Betaserc | Merislon;
  • (SI) Slovenia: Betahistin Pliva | Betaserc | Urutal;
  • (SK) Slovakia: Avertin | Betahistin Actavis | Betahistin Mylan | Betahistin Pliva | Betaserc | Emperin | Meniserc | Microser | Polvertic | Urutal | Vertibetis | Zenostig;
  • (TH) Thailand: Behistin | Betahistin Ratiopharm | Betaserc | Betavert | Histigo | Merislon | Merlin | Serc | Stei | Vertihof 16 | Vertihof 24 | Zystine;
  • (TN) Tunisia: Betagam | Microser | Serc;
  • (TR) Turkey: Betaserc | Betateva | Moreserc | Rotastin bid | Tinserc | Vasoserc | Vertiserc;
  • (TW) Taiwan: Ankumin | Besutin | Betadine | Betahistane | Betaserc | Clensan | Ecycle | Hisbeta | Hynimeru | K.U.N | Meginalisk | Meniace | Menietol | Menitazine | Meris | Merislon | Meslon | Mesytol | Metahislon | Meterlon | Nilasen | Nisulin | Slonlin | Undizz | Windpin;
  • (UA) Ukraine: Be stedy | Betagis | Betahistin | Betahistin lugal | Betahistin Medochemie | Betahistin ratiopharm | Betahistine lugal | Betanorm | Betaserc | Maxhistin | Medogistin | Verisin | Vestagistin;
  • (UG) Uganda: Anatax | Be stedy | Betaserc | Diztrol;
  • (UY) Uruguay: Audipax multidosis | Betistin | Betiver | Histina | Vasotal | Vertikros | Vigotone;
  • (VE) Venezuela, Bolivarian Republic of: Beta histina bluepharma | Betahistina | Betahistina Kern Pharma | Betahistina normon | Betavert | Bethina | Histivert | Menistin | Microser | Serc;
  • (VN) Viet Nam: Agihistine | Betahistin Meyer | Meyerhistin | Mibeserc | Usarhistine | Vacohistin;
  • (ZA) South Africa: Dahide | Hidrist | Menivert | Serc | Trevigo | Vertin
  1. Basura GJ, Adams ME, Monfared A, et al. Clinical practice guideline: Ménière's disease. Otolaryngol Head Neck Surg. 2020;162(2_suppl):S1-S55. doi:10.1177/0194599820909438 [PubMed 32267799]
  2. Coelho DH, Lalwani AK. Medical management of Ménière's disease. Laryngoscope. 2008;118(6):1099-1108. doi:10.1097/MLG.0b013e31816927f0 [PubMed 18418279]
  3. Expert opinion. Senior Renal Editorial Team: Bruce Mueller, PharmD, FCCP, FASN, FNKF; Jason A. Roberts, PhD, BPharm (Hons), B App Sc, FSHP, FISAC; Michael Heung, MD, MS.
  4. Ihler F, Bertlich M, Sharaf K, et al. Betahistine Exerts a Dose-Dependent Effect on Cochlear Stria Vascularis Blood Flow in Guinea Pigs In Vivo. PLoS One. 2012;7(6):e39086. [PubMed 22745706]
  5. Lacour M, van de Heyning PH, Novotny M, et al. Betahistine in the treatment of Ménière’s disease. Neuropsychiatr Dis Treat. 2007;3(4):429-440. [PubMed 19300572]
  6. Magnan J, Özgirgin ON, Trabalzini F, et al. European position statement on diagnosis, and treatment of Meniere's disease. J Int Adv Otol. 2018;14(2):317-321. doi:10.5152/iao.2018.140818 [PubMed 30256205]
  7. Moskowitz HS. Meniere disease: evaluation, diagnosis and management. Post TW, ed. UpToDate. Waltham, MA: UpToDate Inc. http://www.uptodate.com. Accessed July 28, 2022.
  8. Refer to manufacturer's labeling.
  9. Serc (betahistine) [product monograph]. Etobicoke, Ontario, Canada: BGP Pharma ULC: August 2017.
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