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Asthma

Question
Posted by: Jules | 2020/07/01

Q.

Using Betahistine with antihistamine, in order to mitigate asthma contraindication

Let’s start with my use case. For treatment of mild dizziness and migraine, from september 2019 until March 2020, I’ve been taking 2x8mg Betaserc ( Betahistine) daily. -Fortunately, after 1 month the symptoms diminished, almost disappeared in the next months. -Unfortunately, in March 2020, I was diagnosed with a mild form of asthma. This event leads to discontinuation of treatment Betahistine, due to contraindication for asthma. -Fortunately, despite the discontinuation of Betahistine, the dizziness and migraine remained at a minimum level ( the 6 month treatment has done his job). - Unfortunately, in July 2020, with the arrival of the heat wave, dizziness and migraine are back in town. After spring is gone, during summer the asthma symptoms almost fade. What is the inner mechanism of contraindication of Betahistine in asthma? I guess increasing histamine levels throughout the body. I can only speculate that the long Betahistine treatment has triggered my asthma in the spring, but could be also unrelated. Anyway, in order to play on the safe side, my workaround would be using Betahistine with antihistamine, in order to mitigate asthma contraindication. To be more specific, one day 2x8mg Betaserc ( Betahistine), the other day 10mg Claritin(Loratadine). Let’s analyze a little bit their mechanism: Betahistine is a strong antagonist of the histamine H3 receptor and a weak agonist of the histamine H1 receptor https://en.wikipedia.org/wiki/Betahistine Loratadine is a tricyclic antihistamine, which acts as a selective inverse agonist of peripheral histamine H1 receptors https://en.wikipedia.org/wiki/Loratadine, listed at https://en.wikipedia.org/wiki/H1_antagonis Since Betahistine is an antagonist of the histamine H3 receptor, this won’t trigger any asthma symptoms. So, only the H1 agonist from Betahistine, needs to be countered with Loratadine. A few questions would arise: 1) Any side effects of this mash-up? Apparently not. Betahistine may not be as effective if it is taken alongside a medicine containing an antihistamine. https://patient.info/medicine/betahistine-tablets-serc 2) Is this the correct parity? Maybe it should be 1 day of Betaserc and 2 days of Claritin, or vice versa. I guess this needs to be step by step tested. As long as my dizziness /migraine will fade, without triggering asthma, it means I will have found the right formula. Thanks!

Expert's Reply

A.

Asthma Expert
- 2020/07/14

Betahistine with antihistamine antagonises histamine which is a bronchodilator that relaxes the airways. In some people Betahistine can therefore provoke an asthma attack and is relatively contraindicated with this condition.

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