New Release: Alpha testing version has been released.

Betahistine

N07C - Antivertigo preparations ATC N07CA01 Small molecule Natural product

JFDA label: Betastin 16mg Tab

Mechanism of Action

Antagonist of Histamine H3 receptor — Histamine H3 receptor antagonist; Agonist of Histamine H1 receptor — Histamine H1 receptor agonist

TargetActionGene / class
Histamine H1 receptor efficacy AGONIST HRH1
Histamine H3 receptor efficacy ANTAGONIST HRH3

Indications

Approved

  • Ménière disease

Contraindications

Source: Lexicomp

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

Adverse Reactions

Very Common >10%Common 1–10%Uncommon 0.1–1% Rare 0.01–0.1%Very Rare <0.01%Not Known

Cardiac disorders (3)

Not Known Hypotension (including orthostatic and postural hypotension) · tachycardia · ventricular premature contractions (case reports)

Nervous system disorders (6)

Common Headache

Not Known Confusion · convulsions · drowsiness (case reports) · hallucination · paraesthesia

Immune system disorders (3)

Not Known Anaphylaxis · angioedema · hypersensitivity reaction

Gastrointestinal disorders (7)

Common dyspepsia · Nausea

Not Known Abdominal distension · abdominal pain · bloating · peptic ulcer (including exacerbation of previous disease) · vomiting

Skin and subcutaneous tissue disorders (4)

Not Known Pruritus · skin rash · Stevens-Johnson syndrome · urticaria

Respiratory, thoracic and mediastinal disorders (1)

Not Known Dyspnea

Dosing

Source: Lexicomp

Ménière disease (to decrease episodes of vertigo): Oral: 8 to 16 mg 3 times daily or 24 mg twice daily; usual dosage range: 24 to 48 mg daily in divided doses. Doses slowly titrated (ie, approximately every 3 months) up to 480 mg daily (off-label dosing) have been reported in a small number of cases with severe, resistant disease (Lezius 2011).
Refer to adult dosing. Use with caution due to likelihood of decreased hepatic/renal function.
There are no dosage adjustments provided in the manufacturer's labeling (has not been studied); use with caution.
There are no dosage adjustments provided in the manufacturer's labeling (has not been studied). Betahistine primarily undergoes hepatic metabolism; use with caution.

Warnings & Precautions

Source: Lexicomp

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.

Pregnancy & Lactation

Pregnancy

Adverse events were observed in some animal reproduction studies.

Lactation

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.

Chemistry & Properties

2D structure
FormulaC8H12N2
Molecular weight136.2 g/mol
IUPAC nameN-methyl-2-pyridin-2-ylethanamine
CAS5638-76-6
PubChem CID2366
InChIKeyUUQMNUMQCIQDMZ-UHFFFAOYSA-N
logP0.84 (XLogP 0.4)
Polar surface area24.92 Ų
H-bond acceptors / donors2 / 1
Drug-likeness (QED)0.67
Lipinski violations0
SMILESCNCCc1ccccn1

Biology & Pharmacokinetics

Pharmacokinetics

BBB penetrantYes (logBB -0.3)

Enzyme interactions

EnzymeRoleDetail
CYP2C19Substrate
CYP2D6Substrate

Transporters

BCRP (Inhibitor)BSEP (Inhibitor)MRP1 (Inhibitor)OATP1B1 (Inhibitor)OATP1B3 (Inhibitor)P-gp (Inhibitor)P-gp (Substrate)

Registered Products (41)

BrandForm / strengthPackAgentCitizen (JOD)
Vasoserc Tablet 8 mg 30 tab Sun Set Drug Store 2.130
Joswe Mezan Tablet 8 mg 30 tab pack varies Jordan Sweden Medical & Sterilization Co. 2.270
Vertiloc Tablet 16.00 mg 20 tab pack varies Itqan Pharmaceutical Industries/Jordan 2.620
Vasoserc BID Tablet 24 mg 30 tab Sun Set Drug Store 2.940
Vasoserc Forte Tablet 16 mg 30 tab Sun Set Drug Store 2.940
Anatax Tablet 24 mg 30 tab UNITED PHARM.MFG.CO.LTD(UPM)/JORDAN 3.500
Betastin Tablet 16 mg 30 tab pack varies Hayat Pharmaceutical Industries CO.PLC/JORDAN 3.600
Lavistina Tablet 16.0 mg 40 tab Sukhtian Group 3.610
Joswe Mezan Tablet 16 mg 30 tab pack varies Jordan Sweden Medical & Sterilization Co. 3.720
Anatax Tablet 8 mg 60 tab UNITED PHARM.MFG.CO.LTD(UPM)/JORDAN 3.740
Vertiloc Tablet 24.00 mg 30 tab pack varies Itqan Pharmaceutical Industries/Jordan 3.740
Joswe Mezan Tablet 8 mg 60 tab pack varies Jordan Sweden Medical & Sterilization Co. 4.320
Verotec Tablet 8 mg 60 tab pack varies THE JORDANIAN PHARMACEUTICAL MANUFACTURING COMPANY/JORDAN 4.460
Verotec Tablet 8 mg 1500 tab pack varies THE JORDANIAN PHARMACEUTICAL MANUFACTURING COMPANY/JORDAN 4.460
Vertiloc Tablet 8 mg 60 tab pack varies Itqan Pharmaceutical Industries/Jordan 4.570
Plantine Tablet 8 mg 60 tab Dar Al Dawa Development and Investment Co Ltd/Jordan 4.900
Lavistina Tablet 8.0 mg 100 tab Sukhtian Group 5.230
Verotec Tablet 16 mg 50 tab pack varies THE JORDANIAN PHARMACEUTICAL MANUFACTURING COMPANY/JORDAN 5.840
Verotec 24 Tablet 24 mg 50 tab THE JORDANIAN PHARMACEUTICAL MANUFACTURING COMPANY/JORDAN 5.840
Betastin Tablet 16 mg 50 tab pack varies Hayat Pharmaceutical Industries CO.PLC/JORDAN 6.000
Betastin Tablet 24 mg 50 tab pack varies Hayat Pharmaceutical Industries CO.PLC/JORDAN 6.000
Anatax Tablet 16 mg 60 tab UNITED PHARM.MFG.CO.LTD(UPM)/JORDAN 6.130
Vertiloc Tablet 16.00 mg 50 tab pack varies Itqan Pharmaceutical Industries/Jordan 6.240
Vertiloc Tablet 24.00 mg 50 tab pack varies Itqan Pharmaceutical Industries/Jordan 6.240
Vertiloc Tablet 8 mg 100 tab pack varies Itqan Pharmaceutical Industries/Jordan 6.250
BE-Stedy Tablet 16 mg 100 tab AL Rahma Drug Store 6.400
BE-STEDY Tablet 8 mg 100 tab AL Rahma Drug Store 6.500
Dizivert Tablet 16.0 mg 60 tab SAVVY PHARMA/JORDAN 6.640
Dizivert Tablet 8.0 mg 100 tab Savvy Pharms 6.750
Betastin Tablet 16 mg 60 tab pack varies Hayat Pharmaceutical Industries CO.PLC/JORDAN 6.850
Betastin Tablet 24 mg 60 tab pack varies Hayat Pharmaceutical Industries CO.PLC/JORDAN 6.850
Joswe Mezan Tablet 16 mg 60 tab pack varies Jordan Sweden Medical & Sterilization Co. 7.080
Betaserc Tab Tablet 8 mg 100 tab Abu Sheikha Drug Store 7.390
Vertiloc Tablet 16.00 mg 60 tab pack varies Itqan Pharmaceutical Industries/Jordan 7.490
Plantine Tablet 16 mg 60 tab Dar Al Dawa Development and Investment Co Ltd/Jordan 8.040
Dizivert Tablet 24.0 mg 60 tab SAVVY PHARMA/JORDAN 9.230
Betaserc Tab Tablet 16 mg 60 tab Abu Sheikha Drug Store 10.510
Betastin Tablet 16 mg 100 tab pack varies Hayat Pharmaceutical Industries CO.PLC/JORDAN 11.420
Betastin Tablet 24 mg 100 tab pack varies Hayat Pharmaceutical Industries CO.PLC/JORDAN 11.420
BE-STEDY Tablet 24 mg 100 tab AL Rahma Drug Store 12.880
Verotec Tablet 16 mg 900 tab pack varies THE JORDANIAN PHARMACEUTICAL MANUFACTURING COMPANY/JORDAN 90.400