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VERTIN
Generic Name Betahistine HCl
Therapeutic class Anti-vertigo
Pharmacological Class H1 Receptor Agonist/ Vasodilator Agent
Composition  Vertin 8:

Each film coated tablet contains Betahistine HCl 8 mg.

Vertin 16:

Each film coated tablet contains Betahistine HCl 16 mg.

Pregnancy category B
Presentation Available in the pack size as 10 tablets X 10 strips.

What is Vertin?    

Vertin, available as 8 and 16 mg film coated tablets, contains Betahistine Hydrochloride, which is an antivertigo drug first used for treating vertigo associated with Meniere’s disease. It is also commonly used for patients with balance disorders.

In what conditions you can use Vertin?

  • Meniere’s Disease

Symptoms include:

 

  • Central Vestibular Disorder
  • Cochlear disease

How does Vertin work?                         

Vertin is thought to work by improving blood flow in the inner ear, which reduces the buildup of pressure. It is this pressure in the ear which is thought to cause the vertigo (dizziness), tinnitus (ringing in the ears) and hearing loss suffered by people with Ménière’s disease

How to take Vertin?

Vertin tablets should be administered orally and the whole tablet has to be swallowed with water (Crushing or chewing the tablet should be strictly avoided.)

                            

The recommended dosage regimen is:

  • Initially: 8-16 mg 3 times daily (TID), preferably with food.
  • Maintenance dose: 24-48 mg daily
  • For acute attacks: Treatments include 8-16mg up to 3 times daily
  • Preventive measures for recurrent attacks include:

16mg regularly TID seems most effective in Meniere’s      disease

                          

Not recommended for children under the age of 18       years.

                                                                     

 It’s best to take Vertin   with or after food. This way it’s less likely to upset your stomach.

 

Take Vertin only under the prescription of a healthcare provider.

           

                                       

What to do if a dose is missed?

If you forget to take a dose, take it as soon as you remember. If you don’t remember until it’s nearly time for the next dose, skip the missed dose. Never take two doses at the same time. Never take an extra dose to make up for a forgotten one.

If you often forget doses, setting an alarm might be helpful to remind you.

                                            

What do you need to know before you take Vertin?

                                                                                       

Inform your doctor or pharmacist before taking Vertin if you have the following conditions:

 

  • If you have ever had an allergic reaction to any component of the formulation.
  • If you have asthma.
  • If you have a tumour on your adrenal gland, called pheochromocytoma.
  • If you have ever had a peptic ulcer.

 

Do not hesitate to provide information to your healthcare provider about the underlying health conditions that you have and also about other medicines that you are currently taking.

 

Warnings and Precautions:

 

  • It is unlikely that Vertin will affect your ability to
    drive or operate machinery. However, remember the
    diseases for which you are being treated
    (vertigo, tinnitus and hearing loss associated with
    Meniere’s syndrome) can make you feel dizzy or be sick
    and can affect your ability to drive or use machines.
  • If you have been told by your doctor that you have intolerance to some sugars, contact your doctor before taking Vertin.
  • This medicine may take some time to have its full effect,
    so do not worry if you do not feel better right away. Your doctor may adjust the dose depending on your
    Do not adjust the dose unless told to do so by
    your doctor.

 Can Vertin be taken during pregnancy?

 As a precautionary measure, it is preferable to avoid the use of Vertin during pregnancy. In case of unavoidable use, you may consult with your healthcare provider.

        

Can lactating mothers consume Vertin?

Vertin is not recommended for use if you are breastfeeding.  Consult your doctor and discuss the risks associated with the use of this medicine.

                                                                                                 

 

Possible Side effects:  

STOP taking Vertin and see your doctor IMMEDIATELY if you experience:

 An allergic reaction: Symptoms of an allergic reaction
 include skin rashes, inflamed itchy skin, swelling of
 the lips, face, throat or tongue, difficulty breathing or
swallowing.

Other common side effects are:
• feeling sick (nausea)
• headaches
• indigestion (dyspepsia)

If you experience any other symptoms, please speak with your doctor or pharmacist for further advice.

Pharmacodynamics

Betahistine predominantly interacts with histaminergic receptors. Betahistine has a very strong affinity as an antagonist for histamine H3 receptors and a weak affinity as an agonist for histamine H1 receptors

  • H1 receptor agonist would give rise to local vasodilation and increased permeability which helps to reverse the underlying problem of endolymphatic hydrops. Betahistine seems to dilate the blood vessels within the inner ear which can relieve pressure from excess fluid.
  • Betahistine blocks H3 receptors and releases neurotransmitters (histamine, norepinephrine, Ach, GABA). The increased amounts of histamine released from histaminergic nerve endings can stimulate histamine receptors. This stimulation explains the potent vasodilatory effects of betahistine in the inner ear.

 

Pharmacokinetics

Absorption: Rapidly absorbed from the gastrointestinal tract.

Protein binding: Very low (less than 5 %)            

Metabolism: Hepatic

Route of elimination: Renal

Half-life: The half life of elimination is 3.5 hours.

                     

Drug Interactions                 

  • No in-vivo interaction studies have been performed. Based on in-vitro data no in-vivo inhibition on Cytochrome P450 enzymes is expected.
  • In vitro data indicate an inhibition of betahistine metabolism by drugs that inhibit monoamino-oxidase (MAO) including MAO subtype B (e.g. selegiline). Caution is recommended when using betahistine and MAO inhibitors (including MAO-B selective) concomitantly.
  • Betahistine dihydrochloride should not be used concurrently with antihistamines (As betahistine is an analogue of histamine, interaction of betahistine with antihistamines may in theory affect the efficacy of one of these drugs.).