Hydroxyzine

What is Hydroxyzine?

Hydroxyzine is an antihistamine, a medicine used to relieve symptoms of allergies. It is used to treat itching caused by allergies and can also be used in adults to treat anxiety or tension. Hydroxyzine starts working very quickly and may make you drowsy.

When is Hydroxyzine used?

Hydroxyzine is primarily prescribed for:

  • Itching and difficulty sleeping caused by itching.

  • Tension and anxiety in adults.

How is Hydroxyzine used?

Hydroxyzine should be used as directed by your doctor. Contact your doctor or pharmacist if you are not sure. The general recommended dose for this medicine is as follows.

  • This medicine should be taken at the lowest possible dose.

  • This medicine should be taken for the shortest possible time.

  • The tablets should be swallowed whole without chewing, with plenty of water.

  • This medicine should be taken directly after a meal.

  • If you have taken more Hydroxyzine tablets than you should, call your doctor or pharmacist immediately, especially if a child takes too much Hydroxyzine. An overdose can be dangerous, and you may need urgent medical care.

  • If you miss a dose, then skip the missed dose and continue with your regular dosing schedule. Never take a double dose to make up for the forgotten one.

Attention: This medicine can cause drowsiness or dizziness and can therefore interfere with your ability to react. Do not drive or do other activities that call for you to be alert until you know how this medicine affects you.

Alcohol may cause or intensify side effects such as dizziness and drowsiness. You should therefore avoid drinking alcohol while taking this medicine.

For more information on how to use Hydroxyzine, please see the package leaflet.

What doses are available?

Length of treatment and daily dose should be determined by a doctor. The general guidelines for use are as follows:

Adults and children weighing 40 kg or more:

  • For tension and anxiety: 50 mg a day, divided in three doses (12.5 mg in the morning, 12.5 mg in the afternoon and 25 mg in the evening). A doctor may increase this dose to a maximum daily dose of 100 mg if needed.

  • For itching: 25 mg taken at bedtime (initial dose). After this initial dose you may take 25 mg three to four times a day, if needed. However, you should not exceed the maximum daily dose of 100 mg.

Children from 12 months weighing less than 40 kg:

  • For itching: 1 mg per kg of body weight a day, up to a maximum of 2 mg/kg a day, divided into multiple doses to be taken spaced out throughout the day.
    The maximum daily dose for children weighing less than 40 kg is 2 mg/kg a day.

Elderly:

  • For tension and anxiety: 25 mg a day, divided in two doses (12.5 mg in the morning, 12.5 in the evening). A doctor may increase this dose to a maximum daily dose of 50 mg if needed.

  • For itching: 12.5 mg taken at bedtime (initial dose). After this initial dose you may take 12.5 mg three to four times a day, if needed.
    The maximum daily dose for elderly people is 50 mg a day.

Adults with liver or kidney problems require a different dose. Please consult your doctor. For more information on the dosage of Hydroxyzine, see the package leaflet.

What are the side effects of Hydroxyzine?

Hydroxyzine tablets may cause side effects, although not everyone gets them. Side effects that are known to be associated with this medicine include:

  • Sleepiness.

  • Tiredness.

  • Drowsiness.

  • Headache.

  • Dry mouth.

  • Nausea.

  • Dizziness.

  • Difficulty sleeping (insomnia).

  • Unintentional trembling.

For a complete list of possible side effects, see the package leaflet. Consult a doctor if the side effects are severe or if you experience side effects that are not listed on the leaflet. It is particularly important that you see a doctor without delay if you experience severe side effects such as heart rhythm problems (palpitations, breathing problems, loss of consciousness).

When not to use Hydroxyzine?

Hydroxyzine is not suitable for everyone. Do not take this medicine if:

  • You are allergic to the active ingredient hydroxyzine or any other ingredient in this medicine.

  • You are hypersensitive to cetirizine, piperazine derivatives (e.g., levocetirizine), aminophylline or ethylenediamine.

  • You have porphyria.

  • You have a prolonged QT interval (a rare heart problem that may cause irregular heartbeat).

  • You have or have had a heart and/or vascular disease.

  • You have a very slow heart rate.

  • You have untreated low levels of potassium or magnesium.

  • You are taking certain medicines for heart rhythm problems or medicines that influence your heart rate.

  • You have a family history of sudden cardiac death.

In some people this medicine should be used with extreme caution. For instance, if:

  • You have a heart condition.

  • You have an increased chance of fits (seizures), a cataract, blockage of the gut (intestinal obstruction) or urinary tract, muscle weakness, dementia, or irregular heart function.

Pregnancy/ breastfeeding

  • Consult a doctor if you are pregnant or planning to conceive. You should not take Hydroxyzine unless your doctor advises you to do so. Always seek medical advice from your doctor before taking this medicine.

  • This medicine is not suitable for use in breastfeeding women.

For more information on how to use Hydroxyzine, please see the package leaflet. Consult a doctor if you are not sure if Hydroxyzine is suitable for you.

Can Hydroxyzine be used in combination with other medicines?

Hydroxyzine may interact with other medicines.

Do NOT use Hydroxyzine if you are taking any of the following medicines:

  • Certain medicines to treat infections caused by bacteria (e.g., antibiotics such as erythromycin, moxifloxacin, levofloxacin).

  • Certain antifungal medicines (e.g., pentamidine).

  • Medicines to treat certain heart conditions or high blood pressure (e.g., amiodarone, quinidine, disopyramide, sotalol).

  • Certain antipsychotic medicines (e.g., haloperidol).

  • Certain antidepressants (e.g., citalopram, escitalopram).

  • Certain medicines to treat bowel disorders (e.g., prucalopride).

  • Certain medicines to treat allergies.

  • Antimalarial medicines (e.g., mefloquine, hydroxychloroquine).

  • Certain medicines used to treat cancer (e.g., toremifene, vandetanib).

  • Medicines used to treat drug addiction or severe pain (e.g., methadone).

Tell your doctor if you are taking any of the following medicines:

  • Barbiturates (medicines used to induce sleep).

  • Narcotic drugs.

  • Non-opioid pain medications.

  • Betahistine.

  • Tricyclic antidepressants or monoamine oxidase inhibitors (MAOIs).

  • Beta blockers.

  • Class 1c anti-arrhythmic medicines (for heart rhythm disturbances).

  • Phenytoin.

  • Adrenaline.

  • Cimetidine.

  • Cetirizine.

For a complete list of medicines that may interfere with the way Hydroxyzine works, please see the package leaflet. Your doctor will have a list of medicines that you should avoid mixing Hydroxyzine with.

Where can I buy Hydroxyzine?

Hydroxyzine is only available at pharmacies or online pharmacies.

Can I buy Hydroxyzine without a prescription?

Hydroxyzine is a prescription-only medicine. This means you need a prescription from a registered doctor to obtain it.

Sources

Dutch Drug Evaluation Committee. (2021, September). Hydroxyzine-2 HCl 10, coated tablets 10 mg. Medicines Database. Consulted on 21 March 2022 on https://www.geneesmiddeleninformatiebank.nl/ords/f?p=111:3::SEARCH:::P0_DOMAIN,P0_LANG,P3_RVG1:H,NL,50109

Royal Dutch Pharmaceutical Society. (2020, 13 May). Hydroxyzine. Apotheek.nl. Consulted on 21 March 2022 on https://www.apotheek.nl/medicijnen/hydroxyzine

Dutch National Health Care Institute. (n.d.). Hydroxyzine. Farmacotherapeutisch Kompas. https://www.farmacotherapeutischkompas.nl/bladeren/preparaatteksten/h/hydroxyzine#samenstelling

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