What is the recommended dosage for Tablet Vertin (betahistine)?

Recommended Dosage for Vertin (Betahistine)

The standard recommended dosage for Vertin (betahistine) is 48 mg daily, administered for at least 3 months to properly evaluate therapeutic efficacy. 1

Standard Dosing Regimens

For Ménière's Disease and Vestibular Vertigo:

• 48 mg daily is the evidence-based standard dose for maintenance therapy in patients with definite or probable Ménière's disease 1
• This can be administered as either:
  • 16 mg three times daily (tid), or
  • 24 mg twice daily (bid) 2
• Both dosing schedules provide comparable efficacy and tolerability with no significant difference in clinical outcomes 2

Treatment Duration and Efficacy Assessment

• Minimum treatment duration of 3 months is required before evaluating whether the medication is providing benefit 1
• Clinical studies demonstrate maximum efficacy occurs with doses of 32-36 mg daily over 3-8 weeks of treatment 3
• If no improvement in vertigo symptoms after 6-9 months of treatment, continued betahistine therapy is unlikely to be beneficial and should be discontinued 1

Important Dosing Considerations

Higher doses have not shown additional benefit:

• Doses of 144 mg/day have not demonstrated significant improvement compared to the standard 48 mg/day dose or placebo in high-quality trials 1
• The usual therapeutic dose range spans 8-48 mg daily based on over 40 years of clinical experience 4

Specific dosing for different conditions:

• For classic Ménière's syndrome with severe symptoms: 16 mg three times daily (48 mg total) 5
• For less severe peripheral vertigo: 32 mg daily has shown efficacy 6

Absolute Contraindications

Betahistine is completely contraindicated in:

• Pheochromocytoma (absolute contraindication) 1, 7

Use with caution in:

• Asthma patients 1, 7
• History of peptic ulcer disease 1, 7

Common Side Effects to Monitor

• Headache (most frequently reported) 1, 7
• Balance disorder 1
• Nausea and upper gastrointestinal symptoms 1, 7
• These side effects typically diminish with continued treatment 2

Key Clinical Pitfall

Do not expect immediate results - betahistine requires sustained use over months to demonstrate benefit, and premature discontinuation before 3 months may lead to incorrect assessment of treatment failure 1