Bilastine

Class: Second-generation antihistamine (H1-receptor antagonist)

Indications: Allergic rhinitis (seasonal & perennial), chronic idiopathic urticaria

Mechanism: Selectively blocks peripheral H1-receptors. Non-sedating, minimal CNS penetration, rapid onset of action.

Dosage

• Adults & ≥12 yrs: 20 mg once daily (taken on an empty stomach)
• Children 6–11 yrs (≥20 kg): 10 mg once daily
• Children <6 yrs: Safety not well established
• Max dose: 20 mg/day

Major Side Effects

• Headache
• Drowsiness (rare)
• Abdominal pain
• Dizziness
• Fatigue

Contraindications

• Hypersensitivity to bilastine or any component
• Severe renal impairment when co-administered with P-gp inhibitors

Compatible Solvent / Administration

• Oral tablets, oral solution
• Take on an empty stomach (1 hour before or 2 hours after food/fruit juice)

Special Precautions

• Avoid grapefruit and other fruit juices – reduce absorption
• No significant sedation → safe for daily activities
• Generally safe for long-term use in allergic conditions
• Pregnancy Category B – use only if clearly needed