Kestine Tablets 10mg and 20mg (Ebastine)
Highnoon Laboratories LtdDRAP reg. 017681
Prescription required
Highnoon’s Pakistani leaflet says Kestine is to be sold on prescription only, so we dispense both strengths on prescription.
Same day or next day in Karachi, Lahore, Islamabad, Rawalpindi for orders confirmed before 6pm. Tracked courier, 2 to 4 working days everywhere else. Delivery Rs 250 in Rawalpindi and Islamabad, Rs 300 everywhere else, cash on delivery. Delivery details
Prices in PKR, checked 16 October 2026.
What Kestine is
An antihistamine tablet containing ebastine, 10 mg or 20 mg, made in Lahore by Highnoon Laboratories under licence from Almirall of Spain.
- Registered with DRAP under number 017681. (DRAP registry entry).
- Highnoon’s leaflet: “Licenced by LABORATORIOS ALMIRALL SA, Barcelona, Spain.” The 20 mg tablet is registered separately (DRAP reg. 025432), as is Kestine Liquid, 5 mg per 5 ml (DRAP reg. 028369). This page sells the 10 mg and 20 mg tablets, not the liquid.
- DRAP notifies no price for Kestine: every pack is de-controlled, and the price index has no entry. Our price is the one printed on the carton.
- Prescription: Highnoon’s Pakistani leaflet says “To be sold and used on the prescription of a registered medical practitioner only.” That is the condition of sale in Pakistan, so we dispense both strengths on prescription. Before you order, check the heart and medicine cautions below.
What is in each tablet
One active ingredient, from the label claims in DRAP’s registry: “Each Film-coated tablet contains: Ebastine...........................10mg” and “Each film-coated tablet contains: Ebastine.....20mg”.
| Tablet | Ingredient | Amount per tablet |
|---|---|---|
| Kestine 10mg | Ingredient: Ebastine | Amount per tablet: 10 mg |
| Kestine 20mg | Ingredient: Ebastine | Amount per tablet: 20 mg |
Kestine 10mg and 20mg
Both strengths are sold on this page, and both on prescription, as Highnoon’s Pakistani leaflet requires.
| Product | What it is | Price | Prescription |
|---|---|---|---|
| Kestine 10mg Tablets | What it is: Ebastine 10 mg (DRAP reg. 017681) | Price: Rs 298 for 14 | Prescription: We dispense on prescription |
| Kestine 20mg Tablets | What it is: Ebastine 20 mg (DRAP reg. 025432) | Price: Rs 476 for 14 | Prescription: We dispense on prescription |
Both prices are the ones printed on the cartons (2 strips, 14 tablets each), read on 15 October 2026; DRAP notifies no price for either. The Spanish product information for Ebastel Forte 20 mg says its safety in children under 12 has not been established.
What it is used for
Allergy symptoms. The labels list slightly different uses.
| Label | Uses |
|---|---|
| Highnoon (Pakistan), product page | “the symptomatic treatment of allergic rhinitis (seasonal and perennial), whether or not associated with allergic conjunctivitis, and chronic urticaria.” That is hay fever and year-round nasal allergy, with or without itchy eyes, and long-lasting hives. |
| Highnoon (Pakistan), Kestine leaflet | “allergic rhinitis (seasonal and perennial) associated or not with allergic conjunctivitis”, “Idiopathic chronic urticaria” and “allergic dermatitis”. |
| Spain, Ebastel (Almirall) | Allergic rhinitis, with or without allergic conjunctivitis; chronic idiopathic urticaria; and allergic dermatitis. |
| Japan, Ebastel (Sumitomo Pharma) | Hives; eczema and dermatitis, prurigo and itchy skin; allergic rhinitis. |
It is not for an allergic emergency. The Spanish product information for Ebastel 10 mg (Almirall, revised May 2019) says it takes hours to reach its effect, so it should not be used for an acute allergic emergency. For swelling of the face or throat, or difficulty breathing, get emergency help.
Where ebastine is approved, and the US
Ebastine is authorised in Spain, in 17 other European countries and in Japan. It is not approved in the US: the FDA’s database of approved drugs, Drugs@FDA, has no entry for ebastine.
| Where | Status, from the regulator’s own records |
|---|---|
| Spain (AEMPS) | Ebastel, Almirall S.A., authorised since 1989, prescription only. Almirall’s Bactil 10 mg (Laboratorios Almirall, S.L.) is authorised without prescription, for mild allergy symptoms from age 12 (Bactil product information). |
| Europe (EMA list, January 2024) | Nationally authorised in 18 European countries: Belgium, Cyprus, Denmark, Estonia, Finland, France, Germany, Greece, Iceland, Italy, Latvia, Lithuania, Luxembourg, the Netherlands, Norway, Portugal, Spain and Sweden. There is no EU-wide authorisation. |
| Japan (PMDA) | Ebastel, Sumitomo Pharma, in partnership with Almirall. Package insert revised January 2025. |
| United Kingdom | No ebastine product listed on the UK medicines compendium, emc (checked 16 October 2026). |
| United States | Not approved: Drugs@FDA has no entry for ebastine. A US application was filed: the FDA’s Federal Register notice of 13 November 2002 lists “new drug application (NDA) 20-959, Ebastine by Almirall Prodesfarma” for an advisory committee meeting on 20 December 2002, and FDA cancelled that meeting. Neither notice says anything about a decision. |
So “not approved in the US” is not the same as withdrawn or banned. We found no published FDA decision or reason, and no regulator that has withdrawn ebastine for safety reasons: it remains authorised in Spain, across much of Europe and in Japan.
The EU’s latest periodic safety review of ebastine (EMA, published January 2024) kept its authorisations unchanged.
Heart rhythm (QT interval)
Spain’s label carries a heart-rhythm caution; Japan’s does not.
- The Spanish product information for Ebastel 10 mg (Almirall, revised May 2019) says to use it with caution in people with a known heart risk, such as a prolonged QT interval (a heart rhythm measurement on an ECG) or low potassium, or who take medicines that prolong the QT interval or block the CYP3A4 liver enzyme. It names the antifungals ketoconazole and itraconazole and the antibiotic erythromycin. (The label is in Spanish; this is our summary.)
- The same label says that in heart studies, no significant cardiac effects were seen at doses up to ten times the recommended daily dose. With ketoconazole or erythromycin, the QT interval rose only slightly more than with either medicine alone, with no clinically significant effect, but the label still advises caution with them.
- A 1999 paper on the heart studies (Moss and Morganroth, Drug Safety) reported a modest QT increase at high doses and called ebastine’s overall cardiac tolerability “excellent”, while advising caution in long QT syndrome, low potassium, and with azole antifungals or macrolide antibiotics.
- The Japanese package insert for Ebastel (revised January 2025) has no QT warning. It lists palpitations as a rare side effect (under 0.1%) and raised blood pressure with frequency not known.
If you have a heart rhythm problem or low potassium, or take any of the medicines named above, ask a doctor before taking Kestine.
Who should not take it, or should ask a doctor first
From the Spanish product information for Ebastel 10 mg (Almirall, revised May 2019) unless another label is named.
- Must not take it: anyone allergic to ebastine or to any ingredient. The tablets contain lactose.
- A heart rhythm problem, low potassium, or medicines that affect the heart rhythm: see the section above.
- Severe liver disease: the label limits the dose, so take it only as a doctor directs. The Japanese label adds that liver function problems may occur in people with liver disease.
- Kidney disease: the Spanish label says no dose change is needed.
- Children: the Spanish label covers children from 2 years with the liquid. The Japanese label says no clinical trials were done in children. Ask a doctor for a child.
Other medicines, food and alcohol
A few medicines change ebastine levels in the blood.
| Medicine or other | What happens | Source |
|---|---|---|
| Ketoconazole (an antifungal), erythromycin (an antibiotic); itraconazole (an antifungal) | What happens: Ketoconazole and erythromycin raise ebastine levels, and each raises the QT interval. Itraconazole is named among the azole antifungals needing caution. Use with caution. | Source: Spain, 4.4 and 4.5 |
| Rifampicin (a tuberculosis medicine) | What happens: Ebastine levels fall, which may reduce its effect. | Source: Spain, 4.5 |
| Other antihistamines | What happens: Their effects may add up. | Source: Spain, 4.5 |
| Allergy skin tests | What happens: Ebastine can affect the result. The label advises not doing the tests until 5 to 7 days after stopping ebastine: tell the clinic you take it. | Source: Spain, 4.5 |
| Theophylline, warfarin, cimetidine, diazepam, alcohol | What happens: The label says no interactions have been described. | Source: Spain, 4.5 |
| Food | What happens: It can be taken with or without food; food does not change its clinical effect. | Source: Spain, 4.2 and 4.5 |
Pregnancy and breastfeeding
Spain advises avoiding it as a precaution; Japan leaves it to the doctor’s judgement.
| Who | What the labels say |
|---|---|
| Pregnancy | Spain: data are limited, and as a precaution it is preferable to avoid ebastine during pregnancy. Japan: only if the benefit outweighs the risk. |
| Breastfeeding | Spain: it is not known whether ebastine passes into breast milk; as a precaution, preferably avoid it. Japan: weigh continuing or stopping breastfeeding; it passed into milk in rats. |
Side effects
In trials of 5,708 people taking ebastine, the most frequent were headache, dry mouth and drowsiness (Spanish product information for Ebastel 10 mg (Almirall, revised May 2019)).
| How often | Side effects |
|---|---|
| Very common (Spain) | Headache. |
| Common (Spain) | Drowsiness, dry mouth. |
| Rare (Spain) | Palpitations, fast heartbeat; liver problems (hepatitis, abnormal liver tests); allergic reactions including anaphylaxis and swelling under the skin; and others. |
| Serious (Japan) | Shock or anaphylaxis (low blood pressure, difficulty breathing, throat swelling), and liver problems or jaundice. Stop and get help at once. |
Driving: the Spanish label says that at recommended doses it does not affect driving, but some people may feel drowsy or dizzy, so know how it affects you first. The Japanese label is stricter: because it may cause drowsiness, patients should be cautioned about driving.
Checking your pack is genuine
As of 15 October 2026, no DRAP alert, recall or rapid alert names Kestine or ebastine.
- Check that the batch number on the carton matches the batch number on the blister inside, and that the pack is sealed.
We buy only from authorised distributors, and check the batch and expiry on every item before it is packed.
Information as of 15 October 2026. DRAP publishes new alerts on dra.gov.pk.
Returns and replacements
Medicines and supplements can’t be returned once they have left our pharmacy.
- Returned medicine can never go back into saleable stock. That is a safety rule, not a commercial one.
- If an item arrives damaged or wrong, tell us on WhatsApp within 24 hours and we replace it. That is us fixing our mistake, not a return.
- Anything that arrives expired or within a month of expiry we replace or refund, your choice, with no time limit.
Frequently asked questions
What is Kestine used for?
Kestine contains ebastine, an antihistamine. Highnoon lists the symptomatic treatment of allergic rhinitis, seasonal and year-round, with or without allergic conjunctivitis, and chronic urticaria (long-lasting hives). Highnoon’s Pakistani leaflet also lists allergic dermatitis, as does the Spanish label for Ebastel. It is not for an allergic emergency.
Does kestine make you sleep?
It can. In trials of 5,708 people, drowsiness was one of the three most frequent side effects, with headache and dry mouth, according to the Spanish label for Ebastel. That label says it does not affect driving at recommended doses but some people feel drowsy or dizzy; the Japanese label says patients should be cautioned about driving.
Is kestine safe for kidneys?
The Spanish label for Ebastel says no dose change is needed in mild, moderate or severe kidney disease. Severe liver disease is different: the label limits the dose, so take it only as a doctor directs. If you have kidney disease, tell your doctor about all your medicines.
Are Kestine and Rigix the same?
No: they contain different medicines. Kestine contains ebastine and is made by Highnoon Laboratories; Rigix contains cetirizine, by DRAP’s registration 011248, which DRAP lists under AGP Limited. If you want to switch from one to the other, ask a doctor or our pharmacist first.
What is Kestine syrup used for?
Kestine Liquid contains the same medicine, ebastine, at 5 mg in 5 ml, for the same allergy symptoms. The Spanish label for the Ebastel oral solution covers children from 2 years; for a child, ask a doctor how much to give. This page sells the 10 mg and 20 mg tablets, not the liquid.
Questions about Kestine Tablets 10mg and 20mg (Ebastine)?
Send your question on WhatsApp and a pharmacist will come back to you.
Written by the ePharmacyy pharmacy team.
Last checked against the sources below on
DRAP registration
- Kestine 10mg Tablet (017681), Highnoon Laboratories Ltd. DRAP’s registry shows: Active, “Approved / Verified”.
- Kestine 20mg Tablet (025432), Highnoon Laboratories Ltd. DRAP’s registry shows: Active, “Approved / Verified”.
- Kestine 5mg/5ml Liquid (028369), Highnoon Laboratories Ltd. DRAP’s registry shows: Active, “Approved / Verified”.
DRAP publishes no definition of this verification flag, so we can’t tell you what it means. We searched DRAP’s website for “Kestine” and “ebastine” on 16 October 2026 and found no alert naming Kestine or ebastine. When we tested it, the search did not find a word that appears only inside an alert’s attached PDF, so an alert that names a product only in its PDF may not show up. DRAP describes its registered products index as a provisional list that “cannot be used as a reference for any purpose”. Checked against the registry on .
Sources
- DRAP registered products: Kestine 10mg Tablet, registration 017681
- DRAP registered products: Kestine 20mg Tablet, registration 025432
- DRAP notified price index (no entry for Kestine)
- Highnoon Laboratories: Kestine product page
- Highnoon Laboratories: Kestine leaflet, Pakistan (Item Code No. 14003028, PDF)
- AEMPS (Spain): Ebastel 10 mg product information, Almirall S.A., revised May 2019 (in Spanish)
- AEMPS (Spain): Ebastel Forte 20 mg product information, Almirall S.A., revised May 2019 (in Spanish)
- AEMPS (Spain): Bactil 10 mg product information, non-prescription, revised September 2022 (in Spanish)
- PMDA (Japan): Ebastel package insert, Sumitomo Pharma, revised January 2025 (in Japanese, PDF)
- European Medicines Agency: nationally authorised ebastine products (EMA/16935/2024, 11 January 2024, PDF)
- European Medicines Agency: ebastine periodic safety update assessment PSUSA/00001191/202305
- US Federal Register, 13 November 2002: Pulmonary-Allergy Drugs Advisory Committee, notice of meeting (NDA 20-959, ebastine)
- US Federal Register, 19 December 2002: Pulmonary-Allergy Drugs Advisory Committee, cancellation
- Moss AJ, Morganroth J. Cardiac effects of ebastine and other antihistamines in humans. Drug Safety 1999 (PubMed)