bilastine: clinical use

Prescribing considerations

• Confirm that the tablet is appropriate for the patient’s age and swallowing ability.
• Avoid combining bilastine with P-glycoprotein inhibitors in moderate or severe renal impairment.
• Assess QT-prolongation risk, including arrhythmia history, bradycardia, electrolyte disturbance and interacting medicines.
• Explain that food and fruit juice reduce bioavailability.

Contraindications and cautions

• Hypersensitivity to bilastine or any product excipient.

Monitoring

• No routine laboratory monitoring is specified.
• Review symptom control, drowsiness, dizziness, palpitations and suspected hypersensitivity.
• Reassess renal function, electrolyte or cardiac-rhythm risk when clinically relevant.

Clinical pharmacology

Bilastine is a selective peripheral H1-receptor antagonist and a substrate of P-glycoprotein and OATP transporters. It undergoes negligible metabolism, does not meaningfully induce or inhibit CYP450 enzymes, and is largely eliminated unchanged in urine and faeces.

Formulation and product differences

• The selected product is an uncoated conventional tablet.
• Its score line assists swallowing and is not described as a dose-dividing line.
• Orodispersible and oral-solution products exist for some younger children but are separate formulations.

Tablet

Route: Oral

Strengths: 20 mg