Hydroxyzine Hydrochloride

Hydroxyzine Hydrochloride is an antihistamine medication that relieves allergy symptoms such as itching, swelling, and rashes. It is also used for symptomatic relief of anxiety and tension and as a sedative before or after surgery. It works by blocking histamine H1-receptors and suppressing activity in subcortical areas of the central nervous system.

• Symptomatic relief of anxiety and tension (associated with psychoneurosis)
• Pruritus due to allergic conditions (chronic urticaria, atopic and contact dermatoses)
• Sedative (premedication and following general anesthesia)

Adult Dose (Oral):

• Anxiety & Tension: 50-100 mg 4 times daily
• Pruritus (Allergic): Initial: 25 mg at night; may increase up to 25 mg 3-4 times daily
• Sedative (Premedication): 50-100 mg
• Hepatic Impairment: Reduce total daily dose by 33%

Child Dose (Oral):

• Anxiety (under 6 years): 50 mg daily in divided doses; (>6 years): 50-100 mg daily in divided doses
• Pruritus (6 mo-6 yr): Initial 5-15 mg/day, increased to 50 mg/day; (>6 yr): 15-25 mg/day, up to 50-100 mg/day
• Sedative: 0.6 mg/kg
• Hepatic Impairment: Reduce total daily dose by 33%

Renal Dose: CrCl >50 mL/min: No adjustment; <50 mL/min: Administer 50% normal dose

Common Side Effects:

• Sedation
• Nausea
• Vomiting
• Upset stomach
• Constipation
• Diarrhea
• Loss of appetite

Others: Headache, psychomotor impairment, antimuscarinic effects (urinary retention, dry mouth, blurred vision), hypotension, palpitation, arrhythmias, extrapyramidal effects, dizziness, confusion, depression, sleep disturbances, tremor, seizures

Precautions:

• Hydroxyzine may decrease alertness; do not drive or operate machinery
• Avoid alcohol (may cause excessive sleepiness)
• Inform doctor if you have heart disease (may increase risk of heart problems)
• Inform doctor if you have kidney or liver problems
• With CNS depressants, dosage should be reduced
• Avoid concomitant use with MAO inhibitors

Contraindications:

• Porphyria
• Neonates
• Pregnancy (early pregnancy)
• Lactation
• Hypersensitivity to hydroxyzine or any components

Drug Interactions:

• May potentiate Meperidine and barbiturates (dose modification needed in pre-anesthetic therapy)
• Atropine and other belladonna alkaloids are not affected
• Avoid concomitant use with MAO inhibitors

Food Interactions: Hydroxyzine may cause excessive drowsiness with alcohol.

Use in Pregnancy: Safety in early pregnancy not established; contraindicated in early pregnancy.

Use in Lactation: Probably safe; limited data suggests drug does not represent significant risk to baby; larger doses or prolonged use may cause sleepiness and other effects in baby.

Renal Impairment: Half of normal dose should be given; caution required.

Hepatic Impairment: Caution in liver disease; dose adjustment may be needed (reduce total daily dose by 33%).

Overdose: Most common manifestation is hypersedation; induce vomiting or gastric lavage; general supportive care; hypotension may be controlled with IV fluids and Levarterenol or Metaraminol; do not use Epinephrine (hydroxyzine counteracts its pressor action); no specific antidote.