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Serc (betahistine) is an interesting medication used to treat vertigo, balance issues, and Meniere's disease. It is also sometimes used to help with weight loss. The medication can be used in children, but doctor involvement is strongly recommended.

The symptoms treated by Serc can have a variety of causes, and sometimes the cause is unclear despite investigation. The effectiveness of Serc is likewise varied; some patients find it tremendously helpful with others find it does little to nothing. The cause of this difference is likely both individual patient response as well as the root cause of the issue.

Serc works by increasing vasodilation and permeability in the inner ear, at least in part by stimulating release of histamine. This action reduces pressure in the ear, which minimizes or eliminates vertigo and similar symptoms. If increased ear pressure is not the primary cause, Serc is unlikely to provide significant benefit. In most cases, however, inner ear pressure is the cause.

Patients have reported significant improvements using Serc to treat:

• Meniere's disease, a condition in which inner ear pressure produces vertigo, hearing impairment, and tinnitus
• Migraine-associated vertigo
• Motion sickness
• Balance disorders
• Severe dizziness associated with panic attacks or anxiety
• Weight loss, as the medication makes fatty foods unappealing

Serc is not a cure; symptoms may still occur during treatment, though they should be less frequent and less severe. Symptoms will most likely return when treatment ends unless other measures have been taken.

Taking Serc

Serc comes in tablets of 8 mg, 16 mg, and 24 mg. Smaller doses can also be achieved by splitting tablets; for example, splitting a 16 mg tablet will create two 8 mg tablets.

In otherwise healthy patients standard treatment 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 without explicit doctor approval.

Because vertigo often produces nausea and other stomach upset, taking tablets with food and/or fluids is not always a realistic option at the start of treatment. Without food or fluids the medication may produce some mild stomach upset of its own, but this is usually indistinguishable from preexisting stomach upset.

Improvements are usually noticeable within a few days of starting treatment, but may take a few weeks. If there is no difference noticed---if episodes continue to happen even though the medication is being taken---after a month of treatment the medication is unlikely to provide benefit in the future; alternative treatments should be considered.

If the medication does provide benefit, treatment should continue for as long as a doctor recommends.

Side Effects

Serc is unlikely to produce serious side effects, and its milder side effects are very similar to the symptoms it treats; it's often difficult to tell if it's the medication or the condition causing it.

Serious side effects, which warrant emergency medical attention, include:

• Allergic reaction; rash, hives, swelling of the face or throat, etc. These usually occur rapidly after taking the first dose.
• Severe difficulty breathing.

More common side effects are not cause for concern unless very severe, or if they worsen after a dose is taken:

• Upset stomach
• Dizziness
• Headache
• Difficulty sleeping
• Rapid heartbeat

Patients who have a history of peptic ulcer or asthma should use with caution and discuss risks and warning signs with a doctor before starting treatment. Those who have a rare adrenal gland tumor, a condition called pheochromocytoma, should not use the medication at all.

Interactions

There are three categories of other medications that should be avoided while taking Serc:

• MAOIs (monoamine oxidase inhibitors) are the most serious. These can produce dangerous side effects if taken with Serc.
• Antihistamines will make Serc largely inert. Antihistamines are commonly found in over-the-counter cold and allergy medications. For the most part these can be avoided.
• Bronchodilators, including albuterol, will reduce Serc's effectiveness. Discuss use of bronchodilators with a doctor. An alternative to Serc may be necessary.

Other medications may have mild interactions with Serc; double-check with a doctor or pharmacist before taking any, including over-the-counter varieties.