Hydroxyzine

Hydroxyzine Brand Names

ANX | Atarax | Hyzine | Rezine | Vistaril

What is Hydroxyzine

Hydroxyzine is a piperazine class sedating antihistamine (H1-blocker) that is structurally related to buclizine, cyclizine, and meclizine. Hydroxyzine is effective in treating histamine-mediated pruritus or pruritus due to atopy or other allergic conditions.

The drug is considered an effective alternative treatment for anxiety disorders (e.g., generalized anxiety).

Hydroxyzine has been used for many years as a perioperative sedative and anxiolytic and is used to alleviate nausea and control emesis perioperatively.

Although many clinicians believe that hydroxyzine is one of the most sedating H1-blockers, a small study showed that hydroxyzine produced less sedation than either azatadine or clemastine.

The active metabolite of hydroxyzine is cetirizine, which is considered to be a low-sedating antihistamine.

Hydroxyzine has been available as a prescription drug since 1956.

Indications

  1. allergic rhinitis
  2. anxiety
  3. atopic dermatitis
  4. chronic idiopathic urticaria
  5. insomnia
  6. nausea/vomiting
  7. post-operative nausea/vomiting (PONV)
  8. post-operative nausea/vomiting (PONV) prophylaxis
  9. procedural sedation
  10. pruritus
  11. seasonal allergies
  12. urticaria

For the short-term treatment of anxiety, tension, and psychomotor agitation in conditions of emotional stress

Side Effects

  1. abdominal pain
  2. acute generalized exanthematous pustulosis (AGEP)
  3. agitation
  4. appetite stimulation
  5. asthenia
  6. ataxia
  7. blurred vision
  8. confusion
  9. constipation
  10. contact dermatitis
  11. dizziness
  12. drowsiness
  13. dysarthria
  14. dyskinesia
  15. dystonic reaction
  16. fatigue
  17. hallucinations
  18. headache
  19. hemolysis
  20. hypotension
  21. impaired cognition
  22. injection site reaction
  23. insomnia
  24. maculopapular rash
  25. mydriasis
  26. palpitations
  27. priapism
  28. pruritus
  29. psychosis
  30. QT prolongation
  31. rash
  32. respiratory depression
  33. restlessness
  34. seizures
  35. sinus tachycardia
  36. tardive dyskinesia
  37. thrombosis
  38. tissue necrosis
  39. torsade de pointes
  40. tremor
  41. urinary retention
  42. urticaria
  43. weakness
  44. xerophthalmia
  45. xerostomia

Monitoring Parameters

  • LFTs
  • serum creatinine/BUN

Contraindications

  • anticholinergic medications
  • apheresis
  • asthma
  • AV block
  • biliary cirrhosis
  • bradycardia
  • breast-feeding
  • cardiomyopathy
  • celiac disease
  • chronic obstructive pulmonary disease (COPD)
  • closed-angle glaucoma
  • coadministration with other CNS depressants
  • contact lenses
  • dialysis
  • driving or operating machinery
  • electrolyte imbalance
  • ethanol ingestion
  • ethanol intoxication
  • females
  • fever
  • geriatric
  • heart failure
  • hepatic disease
  • human immunodeficiency virus (HIV) infection
  • hydroxyzine hypersensitivity
  • hyperparathyroidism
  • hypocalcemia
  • hypokalemia
  • hypomagnesemia
  • hypothermia
  • hypothyroidism
  • ileus
  • infants
  • intravenous administration
  • labor
  • long QT syndrome
  • myocardial infarction
  • neonates
  • pheochromocytoma
  • pregnancy
  • premature neonates
  • prostatic hypertrophy
  • QT prolongation
  • renal failure
  • renal impairment
  • rheumatoid arthritis
  • sickle cell disease
  • sleep deprivation
  • stroke
  • subcutaneous administration
  • systemic lupus erythematosus (SLE)
  • tissue necrosis
  • torsade de pointes
  • urinary retention

Interactions

  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Codeine
  • Acetaminophen; Dichloralphenazone; Isometheptene
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