Nestibil (Bilastine)

Bilastine acts on histamine‑mediated allergic conditions, providing relief of nasal and skin symptoms.

• Allergic rhinitis: reduces sneezing, nasal congestion, and itching caused by seasonal or perennial allergens.
• Chronic idiopathic urticaria: alleviates wheals and itching associated with chronic hives.
• Seasonal allergic rhinitis: controls hay‑fever symptoms during pollen seasons.

• Bilastine selectively blocks peripheral H1 receptors, preventing histamine from binding to these sites on mast cells, basophils, and sensory nerves. By inhibiting this interaction, it reduces the vascular permeability, smooth‑muscle contraction, and sensory nerve activation that underlie typical allergic manifestations such as itching, swelling, and rhinorrhea.

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

Common Side Effects

• Headache: mild to moderate pain often reported during treatment.
• Dry mouth: sensation of reduced salivation.
• Drowsiness: occasional mild sedation, less frequent than with first‑generation antihistamines.
• Nausea: transient gastrointestinal discomfort.
• Dizziness: brief episodes of light‑headedness.

Serious or Rare Side Effects

• Anaphylaxis: acute, potentially life‑threatening allergic reaction.
• Stevens‑Johnson syndrome: severe skin eruption requiring immediate medical attention.
• Angioedema: swelling of deep skin layers, especially around the eyes and lips.
• Cardiac arrhythmia: irregular heart rhythm reported in rare cases.
• Hepatic injury: abnormal liver function tests indicating possible liver involvement.

Before initiating bilastine therapy, consider the following precautions.

• Pregnancy: consult a healthcare professional; safety data are limited.
• Breastfeeding: weigh potential benefits against possible infant exposure.
• Renal impairment: dose adjustment may be required in severe cases.
• Elderly patients: monitor for increased sedation or dizziness.
• Concomitant medications: review all drugs for possible interactions.
• Store at room temperature: keep in the original packaging, protect from moisture and light.

Bilastine may interact with several medicines, affecting its efficacy or safety.

Major Interactions (Avoid)

• Ketoconazole: can increase bilastine plasma levels, raising risk of side effects.
• Erythromycin: may elevate bilastine exposure, requiring caution.
• Antacids containing aluminium or magnesium: reduce bilastine absorption when taken simultaneously.

Moderate Interactions (Monitor Closely)

• Alcohol: may enhance sedative effects of bilastine.
• Central nervous system depressants (e.g., benzodiazepines): monitor for additive drowsiness.
• Other antihistamines: combined use can increase risk of anticholinergic effects.