Betahistine Contraindications and Precautions

Contraindications and Special Populations

• Betahistine is completely contraindicated in patients with pheochromocytoma 1, 2
• Betahistine should be used with caution in patients with asthma and history of peptic ulcer disease 1, 2

Clinical Context and Recommendations

• The American Academy of Otolaryngology-Head and Neck Surgery does not routinely recommend betahistine for treatment of benign paroxysmal positional vertigo (BPPV), as vestibular suppressant medications in general have not shown significant benefit over particle repositioning maneuvers 3
• For severe or refractory symptoms in conditions like irritable bowel syndrome, vigilance for serotonin syndrome is required when betahistine is used in combination with other serotonergic drugs, according to guidelines from the Gut journal 4