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Betahistine dihydrochloride (brand names Veserc, Serc, Hiserk, Betaserc, Vergo) is an anti-vertigo drug. Nausea can be a side effect, but the patient is generally already experiencing nausea due to the vertigo so it goes largely unnoticed. Patients taking betahistine dihydrochloride may experience several hypersensitivity and allergic reactions.
People taking betahistine may experience several other side effects ranging from mild to serious.
Betahistine chemically is 2-[2-(methylamino)ethyl]pyridine, and is formulated as the dihydrochloride salt. Betahistine has a very strong affinity as an antagonist for histamine H3 receptors and a weak affinity as an agonist for histamine H1 receptors.
More importantly, betahistine has a powerful antagonistic effects at H3 receptors, thereby increasing the levels of neurotransmitters histamine, acetylcholine, norepinephrine, serotonin, and GABA released from the nerve endings. It is postulated that betahistine's increase in the level of serotonin in the brainstem inhibits the activity of vestibular nuclei. The package insert for Serc, a trade name for betahistine, states that patients may experience several gastrointestinal side effects.


The package insert for Serc states that patients may experience nervous-system side effects, including headache.
Betahistine seems to dilate the blood vessels within the inner ear which can relieve pressure from excess fluid and act on the smooth muscle. Primarily, it has a direct stimulating (agonistic) effect on H1 receptors located on blood vessels in the inner ear. The increased amounts of histamine released from histaminergic nerve endings can stimulate receptors. Some nervous system events may also partly be attributable to the underlying condition rather than the medication used to treat it.
The mean plasma half-life is 3a€“4 hours, and excretion is virtually complete in the urine within 24 hours.
This gives rise to local vasodilation and increased permeability, which helps to reverse the underlying problem of endolymphatic hydrops. This stimulation explains the potent vasodilatory effects of betahistine in the inner ear, that are well documented. Wolfgang Wagner reported that betahistine dihydrochloride may cause several allergic and skin-related side effects.


The study by Jeck-Thole and Wagner also reports that patients may experience headache and liver problems, including increased liver enzymes and bile-flow disturbances. Patients experiencing chronic digestive problems may lower their dose to the minimum effective range and by taking betahistine with meals. Any side effects that persist or outweigh the relief of symptoms of the original condition may warrant that the patient consult their physician to adjust or change the medication.
Betahistine is transformed into aminoethylpyridine and hydroxyethylpyridine and excreted with the urine as pyridylacetic acid.
Other hypersensitivity reactions reported include tingling, numbness, burning sensations, shortness of breath and laboured breathing.
Additional digestive problems may require that patients consult their physician in order to find a possible suitable alternative. The study authors suggest that hypersensitivity reactions may be a direct result of betahistine's role in increasing histamine levels throughout the body.



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