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VERTIN 8/16

Generic Name:                    Betahistine HCl

Therapeutic Category:     Anti-vertigo

Pharmacological Class:   Histamine

Composition:                     

Vertin 8

Each film coated tablet contains Betahistine HCl IP8 mg

Vertin 16

Each film coated tablet contains Betahistine HCl IP16 mg

Pregnancy Category:        B

Presentation:                      Available in the pack size as 10 tablets X 10 strips

Description

Betahistine is an antivertigo drug first used for treating vertigo associated with Meniere’s disease. It is also commonly used for patients with balance disorders.

Mechanism of Action

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.

Indications

  • Meniere’s Disease (Vertigo, Dizziness, Tinnitus)
  • Central Vestibular Disorder
  • Cochlear disease

 

Dosage

Route of administration: Oral

  • 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 TDS
  • Preventive measures for recurrent attacks include:

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

Not recommended for children

Pharmacokinetics

Absorption: Rapidly absorbed from the gastrointestinal tract.

Protein binding: Very low

Metabolism: Hepatic

Route of elimination: Renal

Half-life: 3.5 hours

Adverse Effects

  • Headache
  • Low level of gastric side effects
  • Nausea can be a side effect, but the patient is generally already experiencing nausea due to the vertigo so it goes largely unnoticed.
  • Patients taking Vertin may experience several hypersensitivity and allergic reactions

Contraindications

VERTIN is contraindicated in the following populations and situations:

  • Hypersensitivity to betahistine or any component of the formulation
  • Pheochromocytoma*
  • Peptic Ulcer Disease

Precautions

Drug Interactions

  • Enhance hypotensive effect of Tamsulosin when given with antihypertensive drugs (e.g. ACE inhibitors, B-Blockers, Calcium channel blocker etc.), adrenergic neuron blocker, alcohol, alpha blockers, Angiotensin-II receptor antagonist, antipsychotic, anxiolytic and hypnotic drugs.

 

*Terminologies:

Pheochromocytoma: A tumor of the adrenal glands