1. About betahistine
Betahistine is a medicine used to treat the symptoms of Ménière's disease.
The full name of this medicine is betahistine dihydrochloride.
It comes as tablets and is available on prescription only.
2. Key facts
- Betahistine is suitable for adults only.
- You'll usually take your tablets 3 times a day, leaving 6 to 8 hours between doses.
- Common side effects include headache, feeling sick or indigestion.
- It's best to take your tablets with or after food. This way it's less likely to upset your stomach.
- Betahistine is also known by the brand name Serc.
3. Who can and can't take betahistine
Betahistine can be taken by adults (aged 18 years and over). It is not prescribed for children.
Betahistine is not suitable for some people. Tell your doctor or pharmacist if you have:
- had an allergic reaction to betahistine or any other medicines in the past
- high blood pressure due to an adrenal tumour
- ever had a stomach ulcer (sometimes called peptic ulcer)
4. How and when to take it
Betahistine comes as 8mg or 16mg tablets.
Always follow your doctor's instructions about how and when to take your medicine.
It's a good idea to take your betahistine tablets after a meal. It will be less likely to upset your stomach.
How much to take
The usual starting dose is 16mg, taken 3 times a day.
Leave 6 to 8 hours between doses.
When your symptoms are under control, your doctor may reduce your dose to 8mg, taken 3 times a day.
What if I take too much?
Taking too much betahistine can make you feel sick or sleepy, or give you stomach ache.
If you need to go to A&E, do not drive yourself - get someone else to drive you or call for an ambulance.
Take the betahistine packet or leaflet inside it, plus any remaining medicine, with you.
What if I forget my medicine?
If you forget to take a dose of betahistine, take it as soon as you remember. Unless it's less than 2 hours until your next dose. In which case, skip the missed dose and take your next dose at the usual time.
Do not take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
If you forget doses often, it may help to set an alarm to remind you. You could also ask a pharmacist for advice on other ways to help you remember to take your medicine.
5. Side effects
Like all medicines, betahistine can cause side effects, although not everyone gets them. It is generally a very safe medicine.
Common side effects
These common side effects happen in more than 1 in 100 people. They are usually mild and will stop by themselves.
Talk to your pharmacist or doctor if the side effects bother you or do not go away:
- feeling sick (nausea)
- indigestion (acid reflux)
- bloating or mild stomach ache
Serious allergic reaction
In rare cases, it's possible to have a serious allergic reaction (anaphylaxis) to betahistine.
Immediate action required: Call 999 or go to A&E if:
- you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
- you're wheezing
- you get tightness in the chest or throat
- you have trouble breathing or talking
- your mouth, face, lips, tongue or throat start swelling
You could be having a serious allergic reaction and may need immediate treatment in hospital.
These are not all the side effects of betahistine. For a full list, see the leaflet inside your medicine packet.
You can report any suspected side effect to the UK safety scheme.
6. How to cope with side effects
What to do about:
- feeling sick - take betahistine with or after a meal or snack. It may also help if you do not eat rich or spicy food.
- indigestion - take betahistine with or after food. If you get repeated indigestion, contact your doctor as soon as possible. If you need something to ease the discomfort, try taking an antacid, but do not put off going to the doctor.
- bloating or mild stomach ache - try taking betahistine with or after food. If these symptoms continue to bother you, speak to your doctor.
- headache - make sure you rest and drink plenty of fluids. Do not drink too much alcohol. You can take an everyday painkiller like paracetamol. Talk to your doctor if headaches last longer than a week or are severe.
7. Pregnancy and breastfeeding
Betahistine is not usually recommended during pregnancy or while breastfeeding.
However, your doctor may prescribe betahistine if they think the benefits of taking this medicine outweigh the risks. It will depend on how many weeks pregnant you are and why you need to take it.
Speak to your doctor if you are pregnant or trying for a baby. There may be other treatments that are safer for you.
Betahistine and breastfeeding
There is not enough research to know whether betahistine gets into your breast milk. You're generally recommended not to take this medicine if you are breastfeeding.
Non-urgent advice: Tell your doctor or a pharmacist if you're:
- trying to get pregnant
8. Cautions with other medicines
Some medicines and betahistine interfere with each other and can increase your chance of side effects.
Tell your pharmacist or doctor if you're taking:
- medicines called MAO inhibitors, used to treat depression or Parkinson's disease
- antihistamines for allergies such as hay fever
Mixing betahistine with herbal remedies and supplements
There's very little information about taking herbal remedies and supplements while taking betahistine.
Tell your doctor or pharmacist if you're taking any other medicines, including herbal remedies, vitamins or supplements.
9. Common questions
How does betahistine work?
When you have Ménière's disease, your symptoms such as dizziness, hearing loss and ringing in the ears are probably caused by a build-up of fluid in the inner ear.
Betahistine is thought to work by increasing blood flow to this part of your ear and to reduce the amount of fluid there. This helps to reduce the number of attacks you have and to make them milder.
How long does it take to work?
When you start taking betahistine, it may take a couple of weeks before you notice any improvements.
Even when you start feeling better, your doctor may want you to carry on taking the tablets for some time. This is to make sure that the medicine has worked fully.
How long will I take it for?
You may need to take betahistine for a long time to prevent the symptoms of Ménière's disease. You may need to take it for several months.
Is it safe to take for a long time?
Betahistine is unlikely to do you any harm, even if you take it for a long time. It is generally a very safe medicine.
Are there any other medicines to help with my symptoms?
Your doctor may prescribe a short course of prochlorperazine, or a drowsy antihistamine, to help if you're feeling dizzy or being sick (vomiting).
Prochlorperazine helps relieve severe nausea and vomiting. This medicine can make you feel sleepy.
Cinnarizine and cyclizine are types of drowsy (sedating) antihistamines. However, they are less likely to make you feel sleepy than prochlorperazine. Drowsy antihistamines can help if you are feeling a little sick (mild nausea), being sick, or have vertigo.
It's important to take these medicines at the first sign of any symptoms.
You may need to try a few different medicines to find out what works best for you.
Is betahistine different to antihistamines?
Yes, it is. Betahistine is a medicine called a histamine analogue. It works by increasing the effect of a natural substance called histamine in your inner ear.
Antihistamines work by stopping histamine affecting the cells in your body. They are often used to relieve symptoms of allergies, such as hay fever, hives, conjunctivitis and reactions to insect bites or stings.
They can sometimes be used to prevent travel sickness and as a short-term treatment if you have trouble sleeping.
Can I drive or ride a bike with it?
Betahistine is not likely to affect your ability to drive or ride a bike.
However, do not drive if you feel dizzy or if you feel an attack of vertigo coming on.
It is important to inform the Driver and Vehicle Licensing Agency (DVLA) if you're prone to sudden attacks of vertigo without any warning signs.
It's likely that you will have to stop driving until your symptoms are under control.
Will it affect my fertility?
There's no firm evidence to suggest that taking betahistine will reduce fertility in either men or women.
However, speak to a pharmacist or your doctor before taking it if you're trying to get pregnant.
Can I drink alcohol with it?
Yes, you can drink alcohol while taking betahistine.
However, some people say that their symptoms of Ménière's disease improve when they stop drinking alcohol.
Is there any food or drink I need to avoid?
You can eat and drink normally while taking betahistine.
However, some people say their symptoms of Ménière's disease improve by eating a low-salt diet and avoiding caffeine (found in chocolate and drinks like tea, coffee and cola).
Will recreational drugs affect it?
Recreational drugs are unlikely to affect betahistine.
However, taking some recreational drugs may make your symptoms worse when you have Ménière's disease.