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Ménière's disease is a progressive disease of the inner ear characterized by vertigo, tinnitus, and hearing loss.

It has a significant impact on both the physical and social functioning of affected individuals. 2, 13 Betahistine is a histamine-like antivertigo drug used for treating symptoms associated with Ménière's disease.

It is thought to reduce symptoms through its actions on histamine receptors. 4, 12 Betahistine was first approved by the FDA in the 1970s but withdrawn within approximately 5 years due to a lack of evidence supporting its efficacy.

It is currently marketed in

Canada by various companies, including Teva Pharmaceuticals.

Betahistine is indicated for the reduction of recurrent vertigo episodes associated with Ménière's disease in patients 18 years old and above.

Through its actions on the histamine receptors, betahistine provides relief from vertigo associated with Ménière's disease. 3, 5, 11.

When given

Oral, betahistine is rapidly and almost completely absorbed from the gastrointestinal tract. 6, 11 In the fasted state, Cmax is achieved within 1 hour of administration; in the fed state, Cmax is delayed, but the total drug absorption is similar.

Food, therefore, has little effect on the absorption of betahistine.

In a pharmacokinetic study of rats, betahistine was found to be distributed throughout the body.

Human data for betahistine's volume of distribution is not readily available. 6, 9, 11, 14.

Betahistine is metabolized primarily into the inactive metabolite 2-pyridylacetic acid.

There is both clinical and in vitro evidence that monoamine oxidase enzymes are responsible for the metabolism of betahistine. 10, 8, 7, 11 Hover over products below to view reaction partners Betahistine 2-pyridylacetic acid.

Betahistine is mainly excreted in the urine; with approximately 85-91% being detected in urine samples within 24 hours of administration. 6, 9, 11.

The half-life of betahistine is 3-4 hours. 6, 9, 11.

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Symptoms of an overdose with betahistine ( 640 mg), especially during intentional overdoses and combination with other drugs.

In the case of an overdose with betahistine, provide supportive therapy, and contact the local poison control center for further management.