What is the recommended adult dose of bilastine?

Bilastine Adult Dosing

The recommended adult dose of bilastine is 20 mg once daily, taken orally. 1, 2, 3

Standard Dosing Regimen

• Adults and adolescents ≥12 years: 20 mg once daily 1, 3, 4
• Children aged 6 to <12 years: 10 mg once daily 3, 5
• The medication should be taken at least one hour before or no sooner than two hours after a meal to avoid interference with absorption 1, 2

Critical Timing Considerations

Food significantly impacts bilastine absorption, making proper timing essential for therapeutic efficacy. 2

• Bilastine absorption is slowed when taken with food or fruit juice 2
• The fasting state allows for quick absorption 2
• This timing requirement distinguishes bilastine from many other antihistamines and requires clear patient counseling 1

Special Populations

Renal or Hepatic Impairment

• No dosage adjustments are required in patients with renal or hepatic impairment 3
• Bilastine is scarcely metabolized and eliminated through kidneys and feces with a 14-hour half-life 1

Elderly Patients

• No dosage adjustments are required in elderly patients 3
• The standard 20 mg once-daily dose is appropriate across all adult age groups 3

Pharmacokinetic Profile

• Bilastine does not undergo significant metabolism and does not interact with the CYP450 system, limiting potential drug-drug interactions 3
• It is not distributed to the central nervous system, resulting in minimal sedative properties 1, 3
• The elimination half-life is 14 hours, supporting once-daily dosing 1

Clinical Indications

The 20 mg daily dose is approved for:

• Allergic rhinoconjunctivitis (seasonal or perennial) 1, 3
• Chronic urticaria 1, 3, 4

Common Pitfall

The most common prescribing error is failing to instruct patients about the food timing requirement. 2 Patients must understand to take bilastine on an empty stomach—at least one hour before or two hours after meals—to ensure adequate absorption and therapeutic effect.