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Hydroxyzine information from DrugsUpdate  

See Available Brands of Hydroxyzine in India

P - Contraindicated in pregnancy
L - Contraindicated in lactation
FI - Food *

Hydroxyzine is a first-generation antihistamine of the piperazine class that is an H1 receptor antagonist. It was synthesized in the early 1950s. It is used primarily as an antihistamine for the treatment of itches and irritations, an antiemetic for the reduction of nausea, as a weak analgesic by itself and as an opioid potentiator, and as an anxiolytic for the treatment of anxiety.

Hydroxyzine preparations usually require a doctor's prescription, as do other potent antihistamines in many countries; whereas some countries allow hydroxyzine and all or most other antihistamines to be sold over the counter.

Even though it is an effective sedative, hypnotic, and tranquilizer, it shares almost none of the abuse, dependence, addiction, and toxicity potential of other drugs used for the same range of therapeutic reasons. Drugs related to hydroxyzine are cyclizine, buclizine, and meclizine and they share all or most of the benefits, indications, contraindications, cautions, and side effects of hydroxyzine. The second-generation antihistamine cetirizine is one of the metabolites of hydroxyzine.

Pharmacodynamics

Pharmacokinetics

Hydroxyzine blocks histamine H1-receptors on effector cells of the GI tract, blood vessels and respiratory tract; a sedating anihistamine with antimuscarinic and significant sedative properties. It also possesses skeletal muscle relaxing, bronchodilator, antiemetic and analgesic properties.

Absorption

Absorbed rapidly from the GI tract (oral).

Metabolism
Converted to cetirizine (has antihistaminic properties).

Excretion
20 hours (elimination half-life).

Hydroxyzine Indications / Hydroxyzine Uses

Information Not Available

Hydroxyzine Adverse Reactions / Hydroxyzine Side Effects

CNS depression, paradoxical CNS stimulation, dry mouth, thickened respiratory secretions, constipation, blurring of vision, tachycardia, GI disturbances, headache, hypotension, tinnitus.

Precautions

The potentiating action of hydroxyzine must be considered when the drug is used in conjunction with central nervous system depressants such as narcotics, non-narcotic analgesics and barbiturates. therefore, when central nervous system depressants are administered concomitantly with hydroxyzine their dosage should be reduced.

Since drowsiness may occur with use of the drug, patients should be warned of this possibility and cautioned against driving a car or operating dangerous machinery while taking hydroxyzine pamoate. patients should be advised against the simultaneous use of other cns depressant drugs, and cautioned that the effect of alcohol may be increased.


Overdosage
Excessive sedation, hypotension (rare). Symptomatic and supportive treatment. Empty stomach immediately by inducing emesis or by gastric lavage. IV fluids and norepinephrine or metaraminol (do not use epinephrine) if hypotension. Haemodialysis or peritoneal dialysis is probably not effective.

Special Precautions

Renal and hepatic impairment; narrow-angle glaucoma; epilepsy; prostatic hypertrophy; bladder neck obstruction; asthma; COPD. May impair ability to drive or operate machinery.

Other Drug Interactions

Masks ototoxicity of aminoglycoside antibiotics.

Potentially Fatal: Potentiates CNS depression by barbiturates, hypnotics, opioid analgesics, sedatives and neuroleptics. MAOIs, atropine, and TCAs potentiate antimuscarinic effects.

Other Interactions

Food Interaction
Increased CNS depression with alcohol.

Dosage

Oral
Short-term management of anxiety
Adult: 50-100 mg 4 times daily.

Renal impairment: Moderate-severe impairment: Reduce dose by 50%.
Hepatic impairment: Reduce total daily dose by 33%.

Oral
Pruritus in acute and chronic urticaria and dermatosis
Adult: Initially, 25 mg at night increased if required up to 25 mg 3-4 times daily.
Child: 6 months-6 years: 5-15 mg daily, increased to 50 mg/day in divided doses; >6 years: Initially, 15-25 mg/day, increased up to 50-100 mg/day.

Renal impairment: Moderate-severe impairment: Reduce dose by 50%.
Hepatic impairment: Reduce total daily dose by 33%.

Oral
Adjunct to pre- or post-operative sedation
Adult: 50-100 mg.
Child: 600 mcg/kg.

Renal impairment: Moderate-severe impairment: Reduce dose by 50%.
Hepatic impairment: Reduce total daily dose by 33%.

Intramuscular
Prompt control of anxiety or agitation
Adult: Initially, 50-100 mg, may repeat every 4-6 hours if necessary.

Renal impairment: Dose adjustment is required.
Hepatic impairment: Dose adjustment is required.

Incompatibility
Incompatible with aminophylline, benzylpenicillin salts, chloramphenicol sodium succinate, dimenhydrinate, liposomal doxorubicin hydrochloride, thioridazine and some soluble barbiturates.

Food(before/after)

May be taken with or without food.

List of Contraindications

Hydroxyzine and Pregnancy

Contraindicated in pregnancy

Category C: Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Hydroxyzine and Lactation

Contraindicated in lactation

Hydroxyzine and Children

Information Not Available

Hydroxyzine and Geriatic

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.

The extent of renal excretion of Hydroxyzine has not been determined.  Because elderly patients are more likely to have decreased renal function, care should be taken in dose selections.

Sedating drugs may cause confusion and over sedation in the elderly; elderly patients generally should be started on low doses of Hydroxyzine and observed closely.

Hydroxyzine and Other Contraindications

Porphyria, neonates, pregnancy, lactation.

Storage

Intramuscular
Store at 15-30°C.

Oral

Store at 15-30°C.

Lab interference

Intramuscular
Store at 15-30°C.

Oral

Store at 15-30°C.

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