Introduction
Allergies are a common health issue that affects millions of people worldwide. Whether it’s seasonal rhinitis, skin allergies, or urticaria, allergic reactions can severely impact daily life. Bilastine, a second-generation antihistamine, has emerged as an effective solution to combat allergic symptoms with fewer side effects compared to older medications. However, many patients wonder, “Can I take Bilastine twice a day?”
This article delves deep into the pharmacology, recommended dosage, safety profile, and potential risks associated with taking Bilastine more than once in a day. If you’re using this medication or considering doing so, read on to understand how to take Bilastine safely and effectively.
What Is Bilastine?
Bilastine is a non-sedating, second-generation antihistamine primarily prescribed for the treatment of:
- Allergic rhinitis (hay fever)
- Chronic idiopathic urticaria (hives)
- Other allergy-related conditions such as sneezing, runny nose, itchy eyes, and skin rashes
Key Features:
- Typically taken once daily
- Works by blocking histamine H1 receptors
- Does not easily cross the blood-brain barrier, hence less likely to cause drowsiness
- Offers 24-hour relief from symptoms
Recommended Dosage
For Adults and Adolescents (12 years and older):
- 10 mg or 20 mg once daily, usually on an empty stomach or 1 hour before meals
- Maximum recommended dose: 20 mg per day
For Children (Below 12 years):
- Dosage is adjusted based on body weight and medical condition
- Should only be used if prescribed by a pediatrician
Can I Take Bilastine Twice a Day?
The short answer is: No, you should not take Bilastine twice a day without medical supervision.
Bilastine is formulated to provide 24-hour relief from allergic symptoms. Doubling the dosage may not enhance efficacy but can increase the risk of side effects or drug interactions. It is crucial to adhere to the prescribed dose, which is usually once daily.
Let’s explore why exceeding the recommended dose is not advisable.
Why Is Bilastine Taken Once Daily?
Bilastine has a long half-life of approximately 14.5 hours, and its effects can last up to 24 hours. This makes it suitable for once-daily dosing.
Benefits of Once-Daily Dosing:
- Maintains consistent blood levels of the drug
- Reduces the risk of missed doses
- Enhances patient compliance
- Minimizes side effects
Taking it more than once a day offers no added advantage in most cases and might lead to drug accumulation in the body.
What Happens If You Take Bilastine Twice a Day?
If someone takes Bilastine twice in a day, here’s what could happen:
1. Increased Side Effects
Higher doses may lead to:
- Dizziness
- Headache
- Abdominal pain
- Nausea
- Rapid heartbeat
- Dry mouth
Though Bilastine is non-sedating, overdosing may increase the chances of central nervous system (CNS) effects like drowsiness or confusion.
2. Risk of Drug Interactions
If you’re taking other medications (e.g., antifungals, antibiotics, antacids), doubling the dose may interact negatively, leading to toxicity or reduced effectiveness.
3. No Added Efficacy
Research shows that increasing the dose does not necessarily increase relief from allergy symptoms. The drug has a ceiling effect where its effectiveness plateaus beyond a certain dose.
When Might Doctors Recommend a Higher Dose?
There are very limited scenarios in which a doctor may consider increasing the dose of Bilastine, and even then, the decision is based on clinical observation:
For Chronic Urticaria:
- In cases of severe hives, dermatologists may increase the dose up to four times the standard dosage as part of “updosing” treatment under strict medical monitoring. This practice is supported by the EAACI/GA²LEN/EDF/WAO guidelines for treating urticaria.
Important: Even in such cases, the adjustment must be guided by a specialist, and self-medication is dangerous.
Clinical Evidence and Guidelines
Studies on Bilastine Dosage:
- A study published in Allergy journal suggested that increasing doses in chronic urticaria patients resistant to standard antihistamine therapy showed improvement in symptoms with minimal side effects.
- However, these studies were controlled, doctor-supervised, and not intended for general public use.
WHO and EMA Guidelines:
- Endorse the use of once-daily dosing
- Warn against unsupervised dose escalation
What to Do If Symptoms Persist?
If your allergy symptoms persist despite taking Bilastine once daily, do not rush to increase the dose. Instead, follow these steps:
1. Consult Your Doctor
Persistent symptoms may indicate:
- Wrong diagnosis
- Need for combination therapy
- Resistance to current antihistamines
2. Consider Alternative Treatments
Your doctor may prescribe:
- A different antihistamine
- Nasal corticosteroids
- Leukotriene receptor antagonists (like Montelukast)
- Immunotherapy in long-term cases
3. Identify and Avoid Triggers
Make lifestyle modifications to reduce exposure to allergens such as:
- Dust mites
- Pollen
- Mold
- Certain foods or medications
Alternatives to Bilastine
If Bilastine is ineffective at standard doses, doctors may prescribe:
Other Non-Sedating Antihistamines:
- Cetirizine
- Loratadine
- Fexofenadine
- Desloratadine
These alternatives also offer once-daily dosing and may work better for some individuals.
Special Populations: Cautions
For Pregnant Women:
- Bilastine is not recommended unless clearly needed
- Always consult an obstetrician before use
For Elderly:
- Should be used cautiously due to potential kidney or liver impairment
For People with Kidney Disease:
- Dose adjustment may be required
- Doctor must evaluate the risk-benefit ratio
Overdose: What to Do?
If you accidentally take two doses of Bilastine within 24 hours:
- Do not panic
- Monitor for side effects like drowsiness, nausea, dizziness
- Seek medical advice, especially if symptoms appear
- Do not induce vomiting unless directed by a doctor
Summary: Can I Take Bilastine Twice a Day?
Conclusion
To directly answer the question, “Can I take Bilastine twice a day?”—the answer is no, not without a doctor’s advice. Bilastine is formulated for once-daily use, and its 24-hour action makes additional dosing unnecessary for most patients. Overdosing or unsupervised increase in dosage can lead to side effects and may not enhance symptom relief.
If your allergy symptoms are not under control, the best course of action is to consult your doctor, who may adjust your treatment plan, recommend an alternative antihistamine, or explore combination therapies. Never take more than the prescribed amount of Bilastine in a day, and always prioritize medical advice over self-experimentation.
