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Betahistine for Meniere Disease

What is Ménière’s disease?

Ménière’s disease is a rare syndrome that affects the inner ear leading to a variety of symptoms. The most common symptoms include vertigo, ringing of the ear(s), or temporary hearing loss. The feeling of pressure in the ear(s) can also be a symptom. It typically occurs in those age 40-60 years. Meniere’s is an episodic disease, with attacks occurring randomly approximately 6-11 times per year. The exact cause of Ménière’s disease is unknown but has been associated with fluid build-up as well as lesions within the ear.

How do you treat Ménière’s disease?

Treatment of Ménière’s disease focuses on preventing and treating symptom frequency and severity. Initially, lifestyle changes alone are suggested for treatment. If cases where symptoms are not relieved, patients may be treated with a diuretic, an antihistamine, or, where available, betahistine. Invasive therapy/surgery is a last-line option for patients that do not experience symptom relief.

What is betahistine?

Betahistine is an oral medication that is known to increase blood flow to the ear for relief of Ménière’s disease with little to no side effects for most patients. While this medication used to be available in the United States, it is no longer approved by the Food and Drug Administration (FDA) due to lack of evidence for efficacy. However, it is still available for use in other countries. 

Is betahistine effective for Ménière’s disease?

Currently, there is a lack of high-quality evidence regarding the efficacy of betahistine. Most information available comes from small studies with variation between the dosages used, the length of follow-up, and the results. Despite this, some studies do show benefit, and betahistine continues to be used due to the low risk associated with the medication.

Cassie Surber, PharmD Candidate

Marshall University Pharmacy School


  1. Harcourt J, Cosentino S. Betahistine for Meniere’s disease. BMJ. 2016;352:i46. Published 2016 Jan 21. doi:10.1136/bmj.i46
  2. Holmes S, Lalwani AK, Mankekar G. Is Betahistine Effective in the Treatment of  Ménière’s Disease?. Laryngoscope. 2021;131(12):2639-2640. doi:10.1002/lary.29535
  3. Van Esch B, van der Zaag-Loonen H, Bruintjes T, van Benthem PP. Betahistine in Ménière’s Disease or Syndrome: A Systematic Review. Audiol Neurootol. 2022;27(1):1-33. doi:10.1159/000515821

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