Hydroxyzine

Indications
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 mth-6 yr: 5-15 mg daily, increased to 50 mg/day in divided doses; >6 yr: 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 hr 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.
Contraindications
Porphyria, neonates, pregnancy, lactation.
Warnings / Precautions
Renal and hepatic impairment; narrow-angle glaucoma; epilepsy; prostatic hypertrophy; bladder neck obstruction; asthma; COPD. May impair ability to drive or operate machinery.
Adverse Reactions
CNS depression, paradoxical CNS stimulation, dry mouth, thickened respiratory secretions, constipation, blurring of vision, tachycardia, GI disturbances, headache, hypotension, tinnitus.
Overdose Reactions
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.
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.
See Below for More hydroxyzine Drug Interactions
Food Interactions
Increased CNS depression with alcohol.
Mechanism of Actions
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 hr (elimination half-life).
Administration
May be taken with or without food.
Storage Conditions
Intramuscular: Store at 15-30°C. Oral: Store at 15-30°C.
ATC Classification
N05BB01 - hydroxyzine ; Belongs to the class of diphenylmethane derivatives anxiolytics. Used in the management of anxiety, agitation or tension.
Storage
Intramuscular: Store at 15-30°C. Oral: Store at 15-30°C.
Available As
  • Hydroxyzine 10 mg
  • Hydroxyzine Hcl 10 mg
  • Hydroxyzine 25 mg
  • Hydroxyzine Hcl 25 mg
  • Hydroxyzine Hcl 6 mg
  • Hydroxyzine 6 mg
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