What issues should I be aware of before prescribing betahistine?
• Betahistine does not affect driving or psychomotor ability. • Betahistine is an analogue of histamine, therefore caution is advised in: • People who have asthma (although clinical intolerance is relatively rare). • People with a history of peptic ulcer (undesirable effects are also relatively rare). • Betahistine should be used for a sufficient length of time to cover anticipated future attacks, for example, for at least 6–12 months. After a period of 6–12 months some people may wish to attempt a withdrawal of betahistine, restarting it if and when attacks start again. • The manufacturers of betahistine recommend initially taking 16 mg three a day and advise that the duration of this initial dose should be based on the judgement of the clinician. CKS could find no further information on how long this initial dose should be taken for. • No increase in birth defects after clinical use have been shown but in the absence of controlled studies, betahistine should not be routinely used in
