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Histamine analogue (vestibular)

Betahistine dihydrochloride

Brand names: Serc

Adult dose

Dose: 16mg TDS or 8–16mg TDS; titrate to response
Route: Oral
Frequency: TDS

Clinical pearls

  • NICE CKS / ENT UK Ménière's disease: long-term symptomatic control of vertigo
  • Limited high-quality evidence; used widely in UK practice
  • Specialist initiation often required

Contraindications

  • Phaeochromocytoma
  • Active peptic ulcer
  • Asthma (caution)
  • Hypersensitivity

Side effects

  • GI upset
  • Headache
  • Skin rash
  • Bronchospasm (asthma)

Interactions

  • Antihistamines (theoretical antagonism)

Monitoring

  • Symptom diary
  • Hearing
  • Tinnitus

Reference: BNF; NICE CKS Ménière's; ENT UK; https://bnf.nice.org.uk/drugs/betahistine-dihydrochloride/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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