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Hydroxyzine

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Hydroxyzine, Atarax, Vistaril

  • See Also
  1. Antihistamine
  2. Anticholinergic Toxicity
  • Indications
  1. Pruritus
  2. Anxiety
  • Mechanism
  1. See Antihistamine
  2. H1 Receptor Antagonist (First Generation Antihistamine)
  3. Hydroxyzine is a piperazine derivative with Antihistamine, Antiemetic, and Anxiolytic activity
  4. Cetirizine (Zyrtec) is the active metabolite of Hydroxyzine
  • Precautions
  1. Although FDA approved for children, FDA does not recommend routine Antihistamine use age <4 years
    1. Deaths have occurred in younger children related to Anticholinergic Toxicity
  1. Adult: 25 to 100 mg orally or IM three to four times daily as needed
  2. Child (age 4 to 6 years): 50 mg/day divided four times daily orally or IM as needed
    1. Dose: 0.5 mg/kg up to 25-50 mg oral or intramuscular every 4-6 hours as needed
  3. Child (age >=6 years): 50 to 100 mg/day divided four times daily orally or IM as needed
  • Dosing
  • Anxiety
  1. Adult: 50 to 100 mg orally three to four times daily as needed
  • Adverse Effects
  1. See Antihistamine
  2. See Anticholinergic Toxicity
  3. Sedation
  • Safety
  1. Pregnancy category C
  2. Avoid in Lactation
  • Resources
  1. Hydroxyzine (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8e5fce17-936e-46ea-a969-518c952c2091
  • References
  1. Olson (2020) Clinical Pharmacology, Medmaster Miami, p. 146-7
  2. Hamilton (2020) Tarascon Pocket Pharmacopoeia