Ibis (Bilastine)

Bilastine acts on peripheral H1 receptors to relieve allergic symptoms. It is indicated for the following conditions:

• Allergic rhinitis: reduces nasal congestion, sneezing, itching and watery discharge.
• Chronic idiopathic urticaria: alleviates hives and associated itching.
• Seasonal allergic conjunctivitis: helps control eye itching and redness.

• Bilastine selectively blocks peripheral H1 histamine receptors, preventing histamine from binding and triggering the cascade that leads to vasodilation, increased vascular permeability, and sensory nerve activation. By inhibiting this pathway, it reduces the classic signs of allergic inflammation without crossing the blood‑brain barrier, limiting central nervous system effects.

Bilastine is generally well tolerated, but adverse reactions can occur.

Common Side Effects

• Headache: mild to moderate pain often reported.
• Drowsiness: occasional sleepiness, less frequent than with first‑generation antihistamines.
• Dry mouth: reduced salivation leading to mild discomfort.
• Fatigue: feeling of reduced energy.
• Nausea: transient stomach upset.

Serious or Rare Side Effects

• Angioedema: swelling of face, lips or throat requiring urgent care.
• Severe skin reactions: such as Stevens‑Johnson syndrome or toxic epidermal necrolysis.
• Anaphylaxis: rare systemic allergic reaction with respiratory or circulatory collapse.
• Cardiac arrhythmia: extremely rare but reported in susceptible individuals.
• Hepatic injury: isolated cases of liver enzyme elevation.

Before using Bilastine, consider the following safety measures:

• Renal impairment: dose adjustment may be required in patients with reduced kidney function.
• Hepatic impairment: use with caution in moderate liver disease.
• Fruit juice interaction: avoid consuming apple, orange or grapefruit juice within one hour of the dose as it may lower absorption.
• Pediatric use: not recommended for children under 12 years unless specifically authorized.
• Pregnancy and breastfeeding: safety has not been established; consult a healthcare professional.
• Store at below 25°C: keep in the original packaging, protect from moisture and direct sunlight.

Bilastine may interact with other medicines; awareness of the following categories is important.

Major Interactions (Avoid)

• Strong CYP3A4 inhibitors (e.g., ketoconazole, erythromycin): may increase Bilastine plasma levels.
• Fruit juices (apple, orange, grapefruit): significantly reduce oral absorption.
• Concurrent antihistamines: additive sedation or reduced efficacy.

Moderate Interactions (Monitor Closely)

• Alcohol: can enhance drowsiness.
• Antacids containing aluminum or magnesium: may decrease drug absorption.
• QT‑prolonging agents (e.g., certain macrolide antibiotics): monitor cardiac rhythm in at‑risk patients.