Recommended Dosage and Usage of Bilastine for Allergic Conditions
Bilastine should be administered at a dose of 20 mg once daily for adults and adolescents aged 12 years and older, and 10 mg once daily for children aged 6 to <12 years for the treatment of allergic rhinitis and urticaria. 1
Dosage Recommendations
Adults and Adolescents (≥12 years)
- Standard dose: 20 mg once daily
- Timing: Take at least one hour before meals or two hours after meals to avoid interference with absorption 2
- No dosage adjustments required for elderly patients or those with renal or hepatic impairment 1
Children (6 to <12 years)
- Standard dose: 10 mg once daily 1
- Not approved for children under 6 years of age
Clinical Applications
Allergic Rhinitis
- Effective for both seasonal and perennial allergic rhinoconjunctivitis 2
- Efficacious for all nasal symptoms including nasal congestion, rhinorrhea, itching, and sneezing 3
- Also effective for non-nasal symptoms such as ocular itching, tearing, and ocular redness 4
Urticaria
- Recommended for chronic urticaria in adults and children over 12 years 2
- Symptoms (itching and papules) begin to improve from the second day of treatment 2
Pharmacological Properties
- Rapid onset of action and long duration of effect (14-hour elimination half-life) 2, 1
- Non-sedating second-generation H1-antihistamine 5
- No significant metabolism and minimal drug interactions (does not interact with CYP450 system) 1
- Elimination occurs through kidneys and feces 2
Safety Profile
- Generally well-tolerated with adverse event profile similar to placebo 4
- Most common adverse effect: headache 2
- No cardiotoxic effects observed at therapeutic doses 2
- No anticholinergic effects 1
- Minimal sedative properties compared to first-generation antihistamines 5
- No impairment of psychomotor performance or driving ability 5
Clinical Considerations and Precautions
- Food significantly slows absorption; therefore, bilastine should not be taken with meals 3
- Fruit juice can also interfere with absorption 3
- Efficacy comparable to other second-generation antihistamines like desloratadine 4
- Improves quality of life in patients with allergic conditions 1
Comparison with Other Antihistamines
When selecting an antihistamine for allergic conditions, consider that:
- Second-generation antihistamines are generally preferred over first-generation antihistamines due to less sedation and fewer anticholinergic effects 6
- Among second-generation antihistamines, fexofenadine, loratadine, and desloratadine do not cause sedation at recommended doses 6
- Bilastine has been shown to have a favorable safety profile with minimal sedation, similar to other non-sedating antihistamines 5
Bilastine represents an effective option for managing allergic conditions with a good safety profile and once-daily dosing convenience, making it suitable for long-term management of allergic disorders.