Zevert SR (betahistine SR) is used to minimize balance issues, vertigo, tinnitus, hearing loss, and similar symptoms produced by pressure in the inner ear. It works by increasing vasodilation and permeability in the inner ear; it will not provide benefit if inner ear pressure is not causing the symptoms.

Zevert SR is often used to help manage:

• Meniere's disease, a condition in which inner ear pressure produces vertigo, hearing impairment, and tinnitus
• Migraine-associated vertigo
• Balance disorders
• Severe dizziness associated with panic attacks or anxiety

Some individuals find the medication makes fatty foods unappealing, and use Zevert SR off-label to help with weight loss.

This medication should not be used in patients under age 18 without explicit doctor approval.

A Sustained-Release Product

The SR in Zevert SR's name stands for sustained release. This distinguishes Zevert SR from both regular Zevert and Zevert MD, both of which are standard release.

Zevert SR is typically taken just once or twice per day, which the other two formulations are taken 2 to 4 times per day. This has obvious convenience, however, some individuals find standard release products work better. Which to choose is largely a matter of personal preference and individual response.

Dosage & Administration

Zevert SR comes in tablets, which must not be split, crushed, chewed, or otherwise damaged. Regular Zevert tablets can be split, making smaller doses. In the SR version, destroying tablet integrity allows all of the medication to be released at once.

Treatment should always be individualized for a particular patient, as responses vary.

Standard treatment with Zevert is:

• Start with 16 mg, taken 3 or 4 times per day.
• Each dose should be taken with food and a full glass of fluid, if possible.
• After several days of treatment, according to patient response, dosage may be reduced to 8 mg per dose or increased to 24 mg per dose.
• Do not take more than 96 mg per day (four 24 mg tablets) without explicit doctor approval.

There are a few ways in which Zevert SR can fit in here. Patients taking 8 mg 3 times per day can instead take one 24 mg Zevert SR once per day. Patients taking regular 24 mg tablets two times per day may be able to take one Zevert SR tablet instead. Patients taking more than two 24 mg regular tablets may be able to take two Zevert SR tablets.

Treatment is rarely initiated with Zevert SR; smaller doses multiple times per day are preferred at the start of treatment, until patient response and tolerance is established.

Regardless of what sort of tablet is taken, it often takes 6 to 12 months of treatment for maximum benefit. Some improvement should be noticeable within a couple weeks of starting treatment; if no improvement at all is seen after one month, consult a doctor about alternative options.

Results can vary widely. Some users find Zevert SR completely eliminates symptoms, while others notice little difference. This is likely due to the underlying cause of the issue, which can be very difficult to determine.

Off-Label Uses

Off-label use---predominantly for weight loss---is usually very similar to approved uses; start with 16 mg and adjust according to patient response. Zevert SR can again offer lower dosage frequency after an effective dose has been established.

A few studies from well-established organizations have shown that Zevert SR can promote weight loss, or at least help prevent further weight gain. Effects are most pronounced in patients who are obese and under age 50.

Warnings & Side Effects

Zevert SR is unlikely to produce serious side effects if used as directed. More commonly side effects are mild and not cause for concern, including stomach upset, dizziness, and headache.

Patients who have a history of peptic ulcer or asthma should not take Zevert SR---or any Zevert formulation---without discussing risks and warning signs with a doctor. Those who have a rare adrenal gland tumor, a condition called pheochromocytoma, should not take Zevert SR at all.

Medications that should be avoided while taking Zevert SR include:

• MAOIs (monoamine oxidase inhibitors)
• Antihistamines
• Bronchodilators

Other medications may have mild interactions with Zevert SR; double-check with a doctor or pharmacist before mixing treatments, including over-the-counter varieties.