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Hydroxyzine hydrochloride

Oral
Intramuscular
Class
Antihistamines
Subclass
First-generation H1-antihistamines
Substance name
hydrOXYzine
Brand names
Atarax®
Common formulations
Tablet, Film-coated tablet, Solution
Dosage and administration
Adults patients
Symptomatic relief
Anxiety
•
50-100 mg PO QID
Pruritus
•
25 mg PO q6-8h
Induction
Induction of sedation • Premedication or after general anesthesia
•
50-100 mg PO once
Indications for use
Labeled indications
Adults
•
Symptomatic relief of anxiety
•
Symptomatic relief of pruritus
•
Induction of sedation (premedication or after general anesthesia)
Safety risks
Contraindications
Hypersensitivity to hydroxyzine or its components or cetirizine or levocetirizine
Prolonged QT interval
Warnings and precautions
Acute generalized exanthematous pustulosis
•
Maintain a high level of suspicion, as hydroxyzine has rarely been associated with acute generalized exanthematous pustulosis.
CNS depression
•
Use extreme caution when using concurrently with CNS depressants, such as narcotics, non-narcotic analgesics, and barbiturates.
Somnolence
•
Use extreme caution in patients performing activities requiring mental alertness, such as driving or operating machinery.
Torsade de pointes
•
Use caution in patients with risk factors for QT prolongation, congenital long QT syndrome, a family history of long QT syndrome, other conditions predisposing to QT prolongation and ventricular arrhythmia or taking other QT-prolonging drugs, as well as recent myocardial infarction, uncompensated HF, and bradyarrhythmias.
Specific populations
Renal impairment
CrCl > 50 mL/min
•
Use acceptable. No dose adjustment required.
CrCl < 50 mL/min
•
Reduce dose by 50%.
Renal replacement therapy
Any modality
•
No guidance available.
Hepatic impairment
Any severity
•
Use acceptable. No dose adjustment required. Increase dosage interval to q24h in patients with primary biliary cholangitis.
Pregnancy and breastfeeding
Pregnancy
All trimesters • Australia Category: A
•
Avoid use. Evidence of fetal harm in animals. Do not use in early pregnancy.
Breastfeeding
Do not use during breastfeeding.
Unknown amount excreted in breastmilk.
Unknown drug levels in breastfed infants.
May potentially cause adverse effects in breastfed infants.
Some adverse effects on lactation reported.
Adverse reactions
Unknown frequency
•
Acute generalized exanthematous pustulosis, dry mouth, somnolence, tremor, seizure, ↑QT interval, itching, skin rash, urticaria, hallucinations, headache, torsade de pointes
Interactions
Drug(s)
Check Interactions
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