Formulary
Bilastine: Indications, Dosing, Side Effects and Interactions
Bilastine clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Bilastine: Indications, Dosing, Side Effects and Interactions
Bilastine clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Symptomatic relief of allergic rhinoconjunctivitis and urticaria**
- **Child** (By Mouth): 12-17 years 20 mg once daily.
- **Adult** (By Mouth): 20 mg once daily.
**Symptomatic relief of allergic rhinoconjunctivitis and urticaria for bilastine**
- **Child 12-17 years** (By mouth): 20 mg once daily.
Contraindications
Avoid in Acute porphyrias
Side effects
Common or very common Drowsiness; headache Uncommon Anxiety; appetite increased; asthenia; bundle branch block; diarrhoea; dry mouth; dyspnoea; fever; gastritis; gastrointestinal discomfort; insomnia; nasal complaints; nausea; oral herpes; pre-existing condition improved; pruritus; QT interval prolongation; sinus arrhythmia; thirst; tinnitus; vertigo; weight increased Side-effects, further information Non-sedating antihistamines such as bilastine cause less sedation and psychomotor impairment than the older antihistamines, but can still occur; sedation is generally minimal. This is because non-sedating antihistamines penetrate the blood brain barrier to a much lesser extent.
Interactions
**Severe interactions:**
- Interaction with food: Food significantly reduces the oral bioavailability of bilastine by 30%.
**Other interactions (13):**
- Interaction with grapefruit juice: concomitant intake of bilastine 20 mg and grapefruit juice decreased bilastine bioavailability by 30%.
- The mechanism for this interaction is an inhibition of OATP1A2, an uptake transporter for which bilastine is a substrate (see section 5.2).
- Medicinal products that are substrates or inhibitors of OATP1A2, such as ritonavir or rifampicin, may likewise have the potential to decrease plasma concentrations of bilastine.
- Interaction with ketoconazole or erythromycin: Concomitant intake of bilastine 20 mg o.d.
- These changes can be explained by interaction with intestinal efflux transporters, since bilastine is substrate for P-gp and not metabolised (see section 5.2).
- These changes do not appear to affect the safety profile of bilastine and ketoconazole or erythromycin, respectively.
Pregnancy
Avoid-limited information available. Most manufacturers of antihistamines advise avoiding their use during pregnancy; however, there is no evidence of teratogenicity.
Breast feeding
Avoid-no information available. Most antihistamines are present in breast milk in varying amounts; although not known to be harmful, most manufacturers advise avoiding their use in mothers who are breast-feeding.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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