Dosing & Uses
Dosage Forms & Strengths
tablet
- 10mg
- 25mg
- 50mg
capsule
- 25mg
- 50mg
- 100mg
syrup/oral suspension
- 10mg/5mL
injectable solution
- 25mg/mL
- 50mg/mL
Anxiety
Symptomatic relief of anxiety associated with psychoneurosis and as adjunct in organic disease states
50-100 mg PO divided q6hr or 50-100 mg IM divided q4-6hr
Dosing considerations
- Continuation of therapy for >4 months has not been studied; reassess need for therapy periodically
Pruritus
Management of pruritus due to chronic urticaria, contact dermatoses, and histamine-mediated pruritus
25 mg PO/IM divided q6-8hr
Preoperative Sedation
50-100 mg PO or 25-100 mg IM
Dosing considerations
- If treatment is initiated IM, subsequent doses may be administered PO
Nausea & Vomiting (Off-label)
25-100 mg IM
Dosing Modifications
Renal Impairment
- >50 mL/min: Dose adjustment not necessary
- ≤50 mL/min: Administer 50% normal dose
Hepatic Impairment
- Change dosing interval to q24hr in patients with biliary cirrhosis
Dosage Forms & Strengths
tablet
- 10mg
- 25mg
- 50mg
capsule
- 25mg
- 50mg
- 100mg
syrup/oral susp
- 10mg/5mL
injectable solution
- 25mg/mL
- 50mg/mL
Anxiety
<6 years old: 50 mg/day PO divided q6hr
>6 years old: 50-100 mg/day PO divided q6hr
Pruritus
Management of pruritus due to chronic urticaria, contact dermatoses, and histamine-mediated pruritus
<6 years old: 50 mg/day PO divided q6hr
>6 years old: 50-100 mg/day PO divided q6hr
Preoperative Sedation
0.5-1.1 mg/kg IM
Anxiety
Symptomatic relief of anxiety associated with psychoneurosis and as adjunct in organic disease states
50-100 mg PO divided q6hr or 50-100 mg IM divided q4-6hr
Continuation of therapy for >4 months has not been studied; reassess need for therapy periodically
Pruritus
25 mg PO/IM q6-8hr; increased to 25 mg q6-8hr
Nausea & Vomiting (Off-label)
25 mg IM
Dosing Modifications
Advanced age associated with reduced drug clearance and with greater risk of confusion, dry mouth, constipation, and other anticholinergic effects and toxicity; start at low end of dosage range, and observe closely
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (2)
- dronedarone
hydroxyzine and dronedarone both increase QTc interval. Contraindicated.
- thioridazine
hydroxyzine and thioridazine both increase QTc interval. Contraindicated.
Serious - Use Alternative (74)
- amiodarone
hydroxyzine increases toxicity of amiodarone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- amisulpride
amisulpride and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- anagrelide
hydroxyzine and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.
- arsenic trioxide
hydroxyzine and arsenic trioxide both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- artemether/lumefantrine
artemether/lumefantrine and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine
hydroxyzine and asenapine both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- bedaquiline
bedaquiline and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- calcium/magnesium/potassium/sodium oxybates
hydroxyzine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- ceritinib
ceritinib and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- chloroquine
chloroquine and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- citalopram
hydroxyzine increases toxicity of citalopram by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- clozapine
hydroxyzine increases toxicity of clozapine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- crizotinib
crizotinib and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- desflurane
desflurane and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- disopyramide
hydroxyzine and disopyramide both increase QTc interval. Avoid or Use Alternate Drug.
- dofetilide
hydroxyzine and dofetilide both increase QTc interval. Avoid or Use Alternate Drug.
- droperidol
hydroxyzine increases toxicity of droperidol by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- eluxadoline
hydroxyzine, eluxadoline. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that cause constipation. Increases risk for constipation related serious adverse reactions.
- encorafenib
encorafenib and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
entrectinib and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- eribulin
eribulin and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- fexinidazole
fexinidazole and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- flecainide
hydroxyzine and flecainide both increase QTc interval. Avoid or Use Alternate Drug.
- fluoxetine
hydroxyzine increases toxicity of fluoxetine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- foscarnet
hydroxyzine and foscarnet both increase QTc interval. Avoid or Use Alternate Drug.
- glasdegib
hydroxyzine and glasdegib both increase QTc interval. Avoid or Use Alternate Drug.
- hydroxychloroquine sulfate
hydroxyzine and hydroxychloroquine sulfate both increase QTc interval. Avoid or Use Alternate Drug.
- ibutilide
hydroxyzine and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.
- iloperidone
hydroxyzine increases toxicity of iloperidone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- isocarboxazid
isocarboxazid increases effects of hydroxyzine by Other (see comment). Avoid or Use Alternate Drug. Comment: Isocarboxazid should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .
- isoflurane
hydroxyzine and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- lefamulin
lefamulin and hydroxyzine both increase QTc interval. Avoid or Use Alternate Drug.
- lenvatinib
hydroxyzine and lenvatinib both increase QTc interval. Avoid or Use Alternate Drug.
- lofexidine
hydroxyzine and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.
- lopinavir
hydroxyzine and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
- macimorelin
hydroxyzine and macimorelin both increase QTc interval. Avoid or Use Alternate Drug.
- metoclopramide intranasal
hydroxyzine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- midostaurin
hydroxyzine and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
- mifepristone
hydroxyzine and mifepristone both increase QTc interval. Avoid or Use Alternate Drug.
- mobocertinib
hydroxyzine and mobocertinib both increase QTc interval. Avoid or Use Alternate Drug.
- nilotinib
hydroxyzine and nilotinib both increase QTc interval. Avoid or Use Alternate Drug.
- olopatadine intranasal
hydroxyzine and olopatadine intranasal both increase sedation. Avoid or Use Alternate Drug. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- osimertinib
hydroxyzine and osimertinib both increase QTc interval. Avoid or Use Alternate Drug.
- oxaliplatin
hydroxyzine and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- ozanimod
hydroxyzine and ozanimod both increase QTc interval. Avoid or Use Alternate Drug.
- paliperidone
hydroxyzine and paliperidone both increase QTc interval. Avoid or Use Alternate Drug.
- panobinostat
hydroxyzine and panobinostat both increase QTc interval. Avoid or Use Alternate Drug.
- pazopanib
hydroxyzine and pazopanib both increase QTc interval. Avoid or Use Alternate Drug.
- pimavanserin
hydroxyzine and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
- pimozide
hydroxyzine and pimozide both increase QTc interval. Contraindicated.
- pitolisant
hydroxyzine decreases effects of pitolisant by Other (see comment). Avoid or Use Alternate Drug. Comment: Pitolisant increases histamine levels in the brain; therefore, H1 receptor antagonists that cross the blood-brain barrier may reduce the efficacy of pitolisant.
hydroxyzine and pitolisant both increase QTc interval. Avoid or Use Alternate Drug. - ponesimod
hydroxyzine and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.
- procainamide
hydroxyzine increases toxicity of procainamide by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- propafenone
hydroxyzine and propafenone both increase QTc interval. Avoid or Use Alternate Drug.
- quetiapine
hydroxyzine increases toxicity of quetiapine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- quinidine
hydroxyzine increases toxicity of quinidine by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- quinine
hydroxyzine and quinine both increase QTc interval. Avoid or Use Alternate Drug.
- ribociclib
hydroxyzine and ribociclib both increase QTc interval. Avoid or Use Alternate Drug.
- saquinavir
hydroxyzine and saquinavir both increase QTc interval. Avoid or Use Alternate Drug.
- selpercatinib
hydroxyzine and selpercatinib both increase QTc interval. Avoid or Use Alternate Drug.
- sevoflurane
hydroxyzine and sevoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
hydroxyzine and siponimod both increase QTc interval. Avoid or Use Alternate Drug.
- sodium oxybate
hydroxyzine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- sorafenib
hydroxyzine and sorafenib both increase QTc interval. Avoid or Use Alternate Drug.
- sotalol
hydroxyzine increases toxicity of sotalol by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
- tetrabenazine
hydroxyzine and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.
- toremifene
hydroxyzine and toremifene both increase QTc interval. Avoid or Use Alternate Drug.
- tranylcypromine
tranylcypromine increases effects of hydroxyzine by Other (see comment). Avoid or Use Alternate Drug. Comment: Tranylcypromine should not be administered in combination with antihistamines because of potential additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines.
- trazodone
hydroxyzine and trazodone both increase QTc interval. Avoid or Use Alternate Drug.
- vandetanib
hydroxyzine and vandetanib both increase QTc interval. Avoid or Use Alternate Drug.
- vemurafenib
hydroxyzine and vemurafenib both increase QTc interval. Avoid or Use Alternate Drug.
- ziprasidone
hydroxyzine increases toxicity of ziprasidone by QTc interval. Avoid or Use Alternate Drug. Increases risk of torsades de pointes.
Monitor Closely (261)
- albuterol
hydroxyzine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
albuterol and hydroxyzine both increase QTc interval. Use Caution/Monitor. - alfentanil
hydroxyzine and alfentanil both increase sedation. Use Caution/Monitor.
- alfuzosin
alfuzosin and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- alprazolam
hydroxyzine and alprazolam both increase sedation. Use Caution/Monitor.
- amifampridine
hydroxyzine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.
- amitriptyline
hydroxyzine and amitriptyline both increase sedation. Use Caution/Monitor.
hydroxyzine and amitriptyline both increase QTc interval. Use Caution/Monitor. - amobarbital
hydroxyzine and amobarbital both increase sedation. Use Caution/Monitor.
- amoxapine
hydroxyzine and amoxapine both increase sedation. Use Caution/Monitor.
- apomorphine
hydroxyzine and apomorphine both increase sedation. Use Caution/Monitor.
apomorphine and hydroxyzine both increase QTc interval. Use Caution/Monitor. - arformoterol
hydroxyzine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
arformoterol and hydroxyzine both increase QTc interval. Use Caution/Monitor. - aripiprazole
hydroxyzine and aripiprazole both increase sedation. Use Caution/Monitor.
aripiprazole and hydroxyzine both increase QTc interval. Use Caution/Monitor. - armodafinil
hydroxyzine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- atomoxetine
atomoxetine and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- azelastine
azelastine and hydroxyzine both increase sedation. Use Caution/Monitor.
- azithromycin
hydroxyzine increases toxicity of azithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- baclofen
hydroxyzine and baclofen both increase sedation. Use Caution/Monitor.
- belladonna and opium
hydroxyzine and belladonna and opium both increase sedation. Use Caution/Monitor.
- benperidol
hydroxyzine and benperidol both increase sedation. Use Caution/Monitor.
- benzphetamine
hydroxyzine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brexanolone
brexanolone, hydroxyzine. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brompheniramine
brompheniramine and hydroxyzine both increase sedation. Use Caution/Monitor.
- buprenorphine
hydroxyzine and buprenorphine both increase sedation. Use Caution/Monitor.
hydroxyzine and buprenorphine both increase QTc interval. Modify Therapy/Monitor Closely. If coadministration necessary, consider consider dose reduction of one or both drugs due to potential for additive pharmacological effects - buprenorphine buccal
hydroxyzine and buprenorphine buccal both increase sedation. Use Caution/Monitor.
- butabarbital
hydroxyzine and butabarbital both increase sedation. Use Caution/Monitor.
- butalbital
hydroxyzine and butalbital both increase sedation. Use Caution/Monitor.
- butorphanol
hydroxyzine and butorphanol both increase sedation. Use Caution/Monitor.
- caffeine
hydroxyzine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and hydroxyzine both increase sedation. Use Caution/Monitor.
- carisoprodol
hydroxyzine and carisoprodol both increase sedation. Use Caution/Monitor.
- chloral hydrate
hydroxyzine and chloral hydrate both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
hydroxyzine and chlordiazepoxide both increase sedation. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and hydroxyzine both increase sedation. Use Caution/Monitor.
- chlorpromazine
hydroxyzine and chlorpromazine both increase sedation. Use Caution/Monitor.
hydroxyzine increases toxicity of chlorpromazine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes. - chlorzoxazone
hydroxyzine and chlorzoxazone both increase sedation. Use Caution/Monitor.
- cinnarizine
cinnarizine and hydroxyzine both increase sedation. Use Caution/Monitor.
- ciprofloxacin
hydroxyzine and ciprofloxacin both increase QTc interval. Use Caution/Monitor.
- clarithromycin
hydroxyzine increases toxicity of clarithromycin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- clemastine
clemastine and hydroxyzine both increase sedation. Use Caution/Monitor.
- clobazam
hydroxyzine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
- clomipramine
hydroxyzine and clomipramine both increase sedation. Use Caution/Monitor.
hydroxyzine and clomipramine both increase QTc interval. Use Caution/Monitor. - clonazepam
hydroxyzine and clonazepam both increase sedation. Use Caution/Monitor.
- clonidine
clonidine, hydroxyzine. Either increases toxicity of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration enhances CNS depressant effects.
- clorazepate
hydroxyzine and clorazepate both increase sedation. Use Caution/Monitor.
- clozapine
hydroxyzine and clozapine both increase sedation. Use Caution/Monitor.
- codeine
hydroxyzine and codeine both increase sedation. Use Caution/Monitor.
- cyclizine
cyclizine and hydroxyzine both increase sedation. Use Caution/Monitor.
- cyclobenzaprine
hydroxyzine and cyclobenzaprine both increase sedation. Use Caution/Monitor.
- cyproheptadine
cyproheptadine and hydroxyzine both increase sedation. Use Caution/Monitor.
- dantrolene
hydroxyzine and dantrolene both increase sedation. Use Caution/Monitor.
- daridorexant
hydroxyzine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- dasatinib
dasatinib and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- degarelix
degarelix and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- desflurane
desflurane and hydroxyzine both increase sedation. Use Caution/Monitor.
- desipramine
hydroxyzine and desipramine both increase sedation. Use Caution/Monitor.
hydroxyzine and desipramine both increase QTc interval. Use Caution/Monitor. - deutetrabenazine
hydroxyzine and deutetrabenazine both increase sedation. Use Caution/Monitor.
deutetrabenazine and hydroxyzine both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation). - dexchlorpheniramine
dexchlorpheniramine and hydroxyzine both increase sedation. Use Caution/Monitor.
- dexfenfluramine
hydroxyzine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dexmedetomidine
hydroxyzine and dexmedetomidine both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
hydroxyzine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
hydroxyzine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextromoramide
hydroxyzine and dextromoramide both increase sedation. Use Caution/Monitor.
- diamorphine
hydroxyzine and diamorphine both increase sedation. Use Caution/Monitor.
- diazepam
hydroxyzine and diazepam both increase sedation. Use Caution/Monitor.
- diazepam intranasal
diazepam intranasal, hydroxyzine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration may potentiate the CNS-depressant effects of each drug.
- diethylpropion
hydroxyzine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and hydroxyzine both increase sedation. Use Caution/Monitor.
- difenoxin hcl
hydroxyzine and difenoxin hcl both increase sedation. Use Caution/Monitor.
- dimenhydrinate
dimenhydrinate and hydroxyzine both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and hydroxyzine both increase sedation. Use Caution/Monitor.
- diphenoxylate hcl
hydroxyzine and diphenoxylate hcl both increase sedation. Use Caution/Monitor.
- dipipanone
hydroxyzine and dipipanone both increase sedation. Use Caution/Monitor.
- dobutamine
hydroxyzine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dolasetron
dolasetron and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- donepezil
donepezil and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- donepezil transdermal
donepezil transdermal, hydroxyzine. Either decreases effects of the other by pharmacodynamic antagonism. Use Caution/Monitor.
- dopamine
hydroxyzine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
hydroxyzine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
hydroxyzine and dosulepin both increase sedation. Use Caution/Monitor.
- doxepin
hydroxyzine and doxepin both increase sedation. Use Caution/Monitor.
doxepin and hydroxyzine both increase QTc interval. Use Caution/Monitor. - doxylamine
hydroxyzine and doxylamine both increase sedation. Use Caution/Monitor.
- droperidol
hydroxyzine and droperidol both increase sedation. Use Caution/Monitor.
- efavirenz
efavirenz and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- eliglustat
hydroxyzine and eliglustat both increase QTc interval. Use Caution/Monitor.
- ephedrine
hydroxyzine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
hydroxyzine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
hydroxyzine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- erythromycin base
hydroxyzine increases toxicity of erythromycin base by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin ethylsuccinate
hydroxyzine increases toxicity of erythromycin ethylsuccinate by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin lactobionate
hydroxyzine increases toxicity of erythromycin lactobionate by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- erythromycin stearate
hydroxyzine increases toxicity of erythromycin stearate by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- escitalopram
hydroxyzine and escitalopram both increase QTc interval. Use Caution/Monitor.
- esketamine intranasal
esketamine intranasal, hydroxyzine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- estazolam
hydroxyzine and estazolam both increase sedation. Use Caution/Monitor.
- ethanol
hydroxyzine and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and hydroxyzine both increase sedation. Use Caution/Monitor.
- ezogabine
hydroxyzine and ezogabine both increase QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed, particularly when dose titrated to 1200mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.
- fenfluramine
hydroxyzine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fentanyl
fentanyl, hydroxyzine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
- fentanyl intranasal
fentanyl intranasal, hydroxyzine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
- fentanyl transdermal
fentanyl transdermal, hydroxyzine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
- fentanyl transmucosal
fentanyl transmucosal, hydroxyzine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of fentanyl with anticholinergics may increase risk for urinary retention and/or severe constipation, which may lead to paralytic ileus.
- fingolimod
fingolimod and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- flibanserin
hydroxyzine and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.
- fluconazole
hydroxyzine and fluconazole both increase QTc interval. Use Caution/Monitor.
- fluphenazine
hydroxyzine and fluphenazine both increase sedation. Use Caution/Monitor.
hydroxyzine and fluphenazine both increase QTc interval. Use Caution/Monitor. - flurazepam
hydroxyzine and flurazepam both increase sedation. Use Caution/Monitor.
- fluvoxamine
hydroxyzine and fluvoxamine both increase QTc interval. Use Caution/Monitor.
- formoterol
hydroxyzine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fostemsavir
hydroxyzine and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- gabapentin
gabapentin, hydroxyzine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- gabapentin enacarbil
gabapentin enacarbil, hydroxyzine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- ganaxolone
hydroxyzine and ganaxolone both increase sedation. Use Caution/Monitor.
- gemifloxacin
gemifloxacin and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- gemtuzumab
hydroxyzine and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gilteritinib
gilteritinib and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- glycopyrronium tosylate topical
glycopyrronium tosylate topical, hydroxyzine. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Coadministration of glycopyrronium tosylate topical with other anticholinergic medications may result in additive anticholinergic adverse effects.
- goserelin
hydroxyzine and goserelin both increase QTc interval. Use Caution/Monitor.
- gotu kola
gotu kola increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- granisetron
granisetron and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- haloperidol
hydroxyzine and haloperidol both increase sedation. Use Caution/Monitor.
hydroxyzine and haloperidol both increase QTc interval. Use Caution/Monitor. - hawthorn
hawthorn increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- histrelin
hydroxyzine and histrelin both increase QTc interval. Use Caution/Monitor.
- hops
hops increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- hyaluronidase
hydroxyzine decreases effects of hyaluronidase by Other (see comment). Use Caution/Monitor. Comment: Antihistamines, when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients may require larger amounts of hyaluronidase for equivalent dispersing effect.
- hydromorphone
hydroxyzine and hydromorphone both increase sedation. Use Caution/Monitor.
- iloperidone
hydroxyzine and iloperidone both increase sedation. Use Caution/Monitor.
- imipramine
hydroxyzine and imipramine both increase sedation. Use Caution/Monitor.
hydroxyzine and imipramine both increase QTc interval. Use Caution/Monitor. - inotuzumab
hydroxyzine and inotuzumab both increase QTc interval. Modify Therapy/Monitor Closely. If coadministration necessary, obtain baseline ECG to assess initial QT interval and determine frequency of subsequent monitoring; avoid non-essential QT prolonging drug and correct electrolyte imbalances
- isoproterenol
hydroxyzine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- itraconazole
hydroxyzine and itraconazole both increase QTc interval. Use Caution/Monitor.
itraconazole and hydroxyzine both increase QTc interval. Use Caution/Monitor. - ivosidenib
hydroxyzine and ivosidenib both decrease QTc interval. Modify Therapy/Monitor Closely. If coadministration necessary, obtain baseline ECG to assess initial QT interval and determine frequency of subsequent monitoring; avoid non-essential QT prolonging drug and correct electrolyte imbalances
- kava
kava increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- ketamine
ketamine and hydroxyzine both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
hydroxyzine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- lapatinib
hydroxyzine and lapatinib both increase QTc interval. Use Caution/Monitor.
- lasmiditan
lasmiditan, hydroxyzine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant, hydroxyzine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- leuprolide
hydroxyzine and leuprolide both increase QTc interval. Use Caution/Monitor.
- levalbuterol
hydroxyzine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levofloxacin
hydroxyzine and levofloxacin both increase QTc interval. Use Caution/Monitor.
- levorphanol
hydroxyzine and levorphanol both increase sedation. Use Caution/Monitor.
- lisdexamfetamine
hydroxyzine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lithium
hydroxyzine and lithium both increase QTc interval. Use Caution/Monitor.
- lofepramine
hydroxyzine and lofepramine both increase sedation. Use Caution/Monitor.
- lofexidine
hydroxyzine and lofexidine both increase sedation. Use Caution/Monitor.
- loperamide
hydroxyzine and loperamide both increase QTc interval. Use Caution/Monitor.
- loprazolam
hydroxyzine and loprazolam both increase sedation. Use Caution/Monitor.
- lorazepam
hydroxyzine and lorazepam both increase sedation. Use Caution/Monitor.
- lormetazepam
hydroxyzine and lormetazepam both increase sedation. Use Caution/Monitor.
- loxapine
hydroxyzine and loxapine both increase sedation. Use Caution/Monitor.
- loxapine inhaled
hydroxyzine and loxapine inhaled both increase sedation. Use Caution/Monitor.
- lurasidone
lurasidone, hydroxyzine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
- maprotiline
hydroxyzine and maprotiline both increase sedation. Use Caution/Monitor.
hydroxyzine and maprotiline both increase QTc interval. Use Caution/Monitor. - marijuana
hydroxyzine and marijuana both increase sedation. Use Caution/Monitor.
- mefloquine
hydroxyzine and mefloquine both increase QTc interval. Use Caution/Monitor.
- melatonin
hydroxyzine and melatonin both increase sedation. Use Caution/Monitor.
- meperidine
hydroxyzine and meperidine both increase sedation. Use Caution/Monitor.
- meprobamate
hydroxyzine and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
hydroxyzine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
hydroxyzine and metaxalone both increase sedation. Use Caution/Monitor.
- methadone
hydroxyzine and methadone both increase sedation. Use Caution/Monitor.
hydroxyzine increases toxicity of methadone by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes. - methamphetamine
hydroxyzine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
hydroxyzine and methocarbamol both increase sedation. Use Caution/Monitor.
- methylenedioxymethamphetamine
hydroxyzine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- midazolam
hydroxyzine and midazolam both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, hydroxyzine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Concomitant use of barbiturates, alcohol, or other CNS depressants may increase the risk of hypoventilation, airway obstruction, desaturation, or apnea and may contribute to profound and/or prolonged drug effect.
- midodrine
hydroxyzine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mirtazapine
hydroxyzine and mirtazapine both increase sedation. Use Caution/Monitor.
hydroxyzine and mirtazapine both increase QTc interval. Use Caution/Monitor. - modafinil
hydroxyzine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- morphine
hydroxyzine and morphine both increase sedation. Use Caution/Monitor.
- motherwort
hydroxyzine and motherwort both increase sedation. Use Caution/Monitor.
- moxifloxacin
hydroxyzine increases toxicity of moxifloxacin by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- moxonidine
hydroxyzine and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
hydroxyzine and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
hydroxyzine and nalbuphine both increase sedation. Use Caution/Monitor.
- norepinephrine
hydroxyzine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
hydroxyzine and nortriptyline both increase sedation. Use Caution/Monitor.
hydroxyzine and nortriptyline both increase QTc interval. Use Caution/Monitor. - octreotide
hydroxyzine and octreotide both increase QTc interval. Use Caution/Monitor.
- ofloxacin
hydroxyzine and ofloxacin both increase QTc interval. Use Caution/Monitor.
- olanzapine
hydroxyzine and olanzapine both increase sedation. Use Caution/Monitor.
hydroxyzine and olanzapine both increase QTc interval. Use Caution/Monitor. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances - ondansetron
hydroxyzine increases toxicity of ondansetron by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- opium tincture
hydroxyzine and opium tincture both increase sedation. Use Caution/Monitor.
- orphenadrine
hydroxyzine and orphenadrine both increase sedation. Use Caution/Monitor.
- osilodrostat
osilodrostat and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- oxazepam
hydroxyzine and oxazepam both increase sedation. Use Caution/Monitor.
- oxycodone
hydroxyzine and oxycodone both increase sedation. Use Caution/Monitor.
- oxymorphone
hydroxyzine and oxymorphone both increase sedation. Use Caution/Monitor.
- paliperidone
hydroxyzine and paliperidone both increase sedation. Use Caution/Monitor.
- papaveretum
hydroxyzine and papaveretum both increase sedation. Use Caution/Monitor.
- papaverine
hydroxyzine and papaverine both increase sedation. Use Caution/Monitor.
- paroxetine
hydroxyzine and paroxetine both increase QTc interval. Use Caution/Monitor.
- pasireotide
hydroxyzine and pasireotide both increase QTc interval. Use Caution/Monitor.
- passion flower
passion flower increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- pentamidine
hydroxyzine increases toxicity of pentamidine by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- pentazocine
hydroxyzine and pentazocine both increase sedation. Use Caution/Monitor.
- pentobarbital
hydroxyzine and pentobarbital both increase sedation. Use Caution/Monitor.
- perampanel
perampanel and hydroxyzine both increase sedation. Use Caution/Monitor.
- perphenazine
hydroxyzine and perphenazine both increase sedation. Use Caution/Monitor.
hydroxyzine and perphenazine both increase QTc interval. Use Caution/Monitor. - phendimetrazine
hydroxyzine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenelzine
phenelzine increases effects of hydroxyzine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Coadministration of phenelzine and antihistamines may result in additive CNS depressant effects. MAO inhibitors also prolong and intensify anticholinergic effects of antihistamines. .
- phenobarbital
hydroxyzine and phenobarbital both increase sedation. Use Caution/Monitor.
- phentermine
hydroxyzine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
hydroxyzine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
hydroxyzine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
hydroxyzine and pholcodine both increase sedation. Use Caution/Monitor.
- pimozide
hydroxyzine and pimozide both increase sedation. Use Caution/Monitor.
- pirbuterol
hydroxyzine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- posaconazole
hydroxyzine and posaconazole both increase QTc interval. Use Caution/Monitor.
- pregabalin
pregabalin, hydroxyzine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- primaquine
hydroxyzine and primaquine both increase QTc interval. Use Caution/Monitor.
- primidone
hydroxyzine and primidone both increase sedation. Use Caution/Monitor.
- prochlorperazine
hydroxyzine and prochlorperazine both increase sedation. Use Caution/Monitor.
hydroxyzine and prochlorperazine both decrease QTc interval. Use Caution/Monitor. - promethazine
hydroxyzine and promethazine both increase sedation. Use Caution/Monitor.
hydroxyzine and promethazine both decrease QTc interval. Use Caution/Monitor. - propofol
propofol and hydroxyzine both increase sedation. Use Caution/Monitor.
- propylhexedrine
hydroxyzine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
hydroxyzine and protriptyline both increase sedation. Use Caution/Monitor.
hydroxyzine and protriptyline both increase QTc interval. Use Caution/Monitor. - quazepam
hydroxyzine and quazepam both increase sedation. Use Caution/Monitor.
- quetiapine
hydroxyzine and quetiapine both increase sedation. Use Caution/Monitor.
- ramelteon
hydroxyzine and ramelteon both increase sedation. Use Caution/Monitor.
- ranolazine
hydroxyzine and ranolazine both increase QTc interval. Use Caution/Monitor.
- rilpivirine
hydroxyzine and rilpivirine both increase QTc interval. Use Caution/Monitor.
- risperidone
hydroxyzine and risperidone both increase sedation. Use Caution/Monitor.
hydroxyzine and risperidone both increase QTc interval. Use Caution/Monitor. - romidepsin
hydroxyzine and romidepsin both increase QTc interval. Use Caution/Monitor.
- salmeterol
hydroxyzine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- scullcap
hydroxyzine and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
hydroxyzine and secobarbital both increase sedation. Use Caution/Monitor.
- sertraline
hydroxyzine and sertraline both increase QTc interval. Use Caution/Monitor.
- sevoflurane
sevoflurane and hydroxyzine both increase sedation. Use Caution/Monitor.
- shepherd's purse
hydroxyzine and shepherd's purse both increase sedation. Use Caution/Monitor.
- solifenacin
hydroxyzine and solifenacin both increase QTc interval. Use Caution/Monitor.
- stiripentol
stiripentol, hydroxyzine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
- sufentanil
hydroxyzine and sufentanil both increase sedation. Use Caution/Monitor.
- sunitinib
hydroxyzine and sunitinib both increase QTc interval. Use Caution/Monitor.
- tacrolimus
hydroxyzine and tacrolimus both increase QTc interval. Use Caution/Monitor.
- tapentadol
hydroxyzine and tapentadol both increase sedation. Use Caution/Monitor.
- telavancin
hydroxyzine and telavancin both increase QTc interval. Use Caution/Monitor.
- temazepam
hydroxyzine and temazepam both increase sedation. Use Caution/Monitor.
- terbutaline
hydroxyzine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
hydroxyzine and thioridazine both increase sedation. Use Caution/Monitor.
- thiothixene
hydroxyzine and thiothixene both increase sedation. Use Caution/Monitor.
- topiramate
hydroxyzine and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
hydroxyzine and tramadol both increase sedation. Use Caution/Monitor.
- trazodone
hydroxyzine and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
hydroxyzine and triazolam both increase sedation. Use Caution/Monitor.
- triclabendazole
hydroxyzine and triclabendazole both increase QTc interval. Use Caution/Monitor.
- triclofos
hydroxyzine and triclofos both increase sedation. Use Caution/Monitor.
- trifluoperazine
hydroxyzine and trifluoperazine both increase sedation. Use Caution/Monitor.
hydroxyzine and trifluoperazine both decrease QTc interval. Use Caution/Monitor. - trimipramine
hydroxyzine and trimipramine both increase sedation. Use Caution/Monitor.
hydroxyzine and trimipramine both increase QTc interval. Use Caution/Monitor. - triprolidine
hydroxyzine and triprolidine both increase sedation. Use Caution/Monitor.
- triptorelin
hydroxyzine and triptorelin both increase QTc interval. Use Caution/Monitor.
- valbenazine
valbenazine and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- valerian
valerian increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
- vardenafil
hydroxyzine and vardenafil both increase QTc interval. Use Caution/Monitor.
- venlafaxine
hydroxyzine and venlafaxine both decrease QTc interval. Use Caution/Monitor.
- voclosporin
hydroxyzine and voclosporin both increase QTc interval. Use Caution/Monitor.
- vorinostat
hydroxyzine and vorinostat both increase QTc interval. Use Caution/Monitor.
- xylometazoline
hydroxyzine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
hydroxyzine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
hydroxyzine and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
hydroxyzine and ziprasidone both increase sedation. Use Caution/Monitor.
- zotepine
hydroxyzine and zotepine both increase sedation. Use Caution/Monitor.
Minor (6)
- ashwagandha
ashwagandha increases effects of hydroxyzine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.
- brimonidine
brimonidine increases effects of hydroxyzine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- eucalyptus
hydroxyzine and eucalyptus both increase sedation. Minor/Significance Unknown.
- nettle
nettle increases effects of hydroxyzine by pharmacodynamic synergism. Minor/Significance Unknown. (High dose nettle; theoretical interaction) May enhance CNS depression.
- sage
hydroxyzine and sage both increase sedation. Minor/Significance Unknown.
- Siberian ginseng
Siberian ginseng increases effects of hydroxyzine by pharmacodynamic synergism. Minor/Significance Unknown. May enhance CNS depression.
Adverse Effects
Frequency Not Defined
Anticholinergic: Dry mouth
Central nervous system: Drowsiness (usually transitory and may disappear in a few days of continued therapy or upon reduction of the dose), involuntary motor activity (tremor, convulsions) usually with doses considerably higher than those recommended
Clinically significant respiratory depression has not been reported at recommended doses
Postmarketing Reports
Body as a whole: Allergic reaction
Nervous system: Headache
Psychiatric: Hallucination
Skin and appendages: Pruritus, rash, urticaria, fixed drug eruptions
Warnings
Contraindications
Documented hypersensitivity or related product including cetirizine and levocetirizine and components of the formulation
Prolonged QT interval
SC, intra-arterial, or IV administration
Cautions
Nursing mothers
May cause CNS depression resulting in drowsiness; avoid driving or operating dangerous machinery
May cause oversedation and confusion in elderly patients; start on lower doses and monitor closely; avoid use
IM only for parenteral use; switch to PO ASAP
Use caution in patients with narrow-angle glaucoma, prostatic hyperplasia, or respiratory disease (asthma or COPD)
Hydroxyzine may rarely cause acute generalized exanthematous pustulosis (AGEP), a serious skin reaction characterized by fever and numerous small, superficial, non-follicular, sterile pustules, arising within large areas of edematous erythema; if signs or symptoms suggest AGEP, do not resume use of hydroxyzine and consider alternative therapy; avoid cetirizine or levocetirizine in patients who have experienced AGEP or other hypersensitivity reactions with hydroxyzine, due to risk of cross-sensitivity
Drug interaction interview
- Caution recommended during concomitant use of drugs known to prolong QT interval including Class 1A (e.g., quinidine, procainamide) or Class III (e.g., amiodarone, sotalol) antiarrhythmics, certain antipsychotics (e.g., ziprasidone, iloperidone, clozapine, quetiapine, chlorpromazine), certain antidepressants (e.g., citalopram, fluoxetine), certain antibiotics (e.g., azithromycin, erythromycin, clarithromycin, gatifloxacin, moxifloxacin); and others (e.g., pentamidine, methadone, ondansetron, droperidol)
Pregnancy & Lactation
Pregnancy category: Considered to be contraindicated in early (1st trimester) pregnancy until more human pregnancy data available; limited experience in human pregnancy, either for drug itself or drugs in same class or with similar mechanisms of action, including 1st trimester, current limited data suggests that the drug does not represent a significant risk of developmental toxicity including growth restriction, structural anomalies, functional/behavioral deficits, or death at any time in pregnancy
Lactation: Excretion in milk unknown; use with caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
H1-receptor antagonist with low to moderate antihistaminic properties; inhibits respiratory, vascular, and GI smooth-muscle constriction
Moderate to high anticholinergic and antiemetic properties
Absorption
Onset: 15-30 min (PO)
Duration: Sedation, 4-6 hr; antipruritic, 1-12 hr; histamine-induced wheal and flare, 2-36 hr
Peak serum time: 1-2 hr
Distribution
Vd: 16 L/kg (adults); 23 L/kg (elderly)
Metabolism
Metabolized by liver
Elimination
Half-life: 20 hr (adults); 29 hr (elderly); 37 hr (hepatic dysfunction)
Excretion: Urine
Administration
IM Incompatibilities
Additive: Aminophylline, amobarbital, chloramphenicol, ketorolac, penicillin G sodium/potassium, pentobarbital, phenobarbital
Syringe: Aminophylline, dimenhydrinate, haloperidol, heparin, ketorolac, penicillin, pentobarbital, phenytoin, ranitidine, vitamin B complex with C
IM Compatibilities
Additive (partial list): Cisplatin, cyclophosphamide, cytarabine, dimenhydrinate, etoposide, lidocaine, methotrexate, nafcillin
Syringe (partial list): Atropine, buprenorphine, cimetidine, diphenhydramine, fentanyl, glycopyrrolate, lidocaine, meperidine, midazolam, morphine, promethazine, scopolamine, sufentanil
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| hydroxyzine HCl oral - | 50 mg tablet |  | |
| hydroxyzine HCl oral - | 25 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg tablet |  | |
| hydroxyzine HCl oral - | 25 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg/5 mL solution |  | |
| hydroxyzine HCl oral - | 25 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg/5 mL solution |  | |
| hydroxyzine HCl oral - | 50 mg tablet |  | |
| hydroxyzine HCl oral - | 50 mg tablet |  | |
| hydroxyzine HCl oral - | 50 mg tablet |  | |
| hydroxyzine HCl oral - | 25 mg tablet |  | |
| hydroxyzine HCl oral - | 25 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg/5 mL solution |  | |
| hydroxyzine HCl oral - | 25 mg tablet |  | |
| hydroxyzine HCl oral - | 25 mg tablet |  | |
| hydroxyzine HCl oral - | 25 mg tablet |  | |
| hydroxyzine HCl oral - | 50 mg tablet |  | |
| hydroxyzine HCl oral - | 50 mg tablet |  | |
| hydroxyzine HCl oral - | 10 mg tablet |  | |
| hydroxyzine HCl oral - | 25 mg tablet |  | |
| hydroxyzine HCl oral - | 50 mg tablet |  | |
| hydroxyzine HCl intramuscular - | 50 mg/mL vial |  | |
| hydroxyzine HCl intramuscular - | 25 mg/mL vial |  | |
| hydroxyzine HCl intramuscular - | 50 mg/mL vial |  | |
| hydroxyzine HCl intramuscular - | 50 mg/mL vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
hydroxyzine HCl oral
HYDROXYZINE HYDROCHLORIDE - ORAL
(hye-DROX-i-zeen HYE-droe-KLOR-ide)
COMMON BRAND NAME(S): Atarax
USES: Hydroxyzine is used to treat itching caused by allergies. It is an antihistamine and works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. Hydroxyzine may also be used short-term to treat anxiety or to help you feel sleepy/relaxed before and after surgery.
HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually three or four times daily. If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.The dosage is based on your age, medical condition, and response to treatment. In children, the dosage may also be based on weight. Do not increase your dose or take this medication more often than directed.Tell your doctor if your condition does not improve or if it worsens.
SIDE EFFECTS: Drowsiness, dizziness, blurred vision, constipation, or dry mouth may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.To relieve dry mouth, suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as restlessness, confusion, hallucinations), shaking (tremor), difficulty urinating.Get medical help right away if you have any very serious side effects, including: seizures, fast/irregular heartbeat, severe dizziness, fainting.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking hydroxyzine, tell your doctor or pharmacist if you are allergic to it; or to cetirizine; or to levocetirizine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as emphysema, asthma), high pressure in the eye (glaucoma), high blood pressure, kidney problems, liver problems, seizures, stomach/intestine problems (such as ulcer, blockage), overactive thyroid (hyperthyroidism), difficulty urinating (for example, due to enlarged prostate).Hydroxyzine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before taking hydroxyzine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about taking hydroxyzine safely.This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Liquid products may contain sugar and/or alcohol. Caution is advised if you have diabetes, liver disease, or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.Children may be more sensitive to the side effects of this drug. This drug can often cause excitement in young children instead of drowsiness.Older adults may be more sensitive to the side effects of this drug, especially drowsiness, confusion, constipation, trouble urinating or QT prolongation (see above). Drowsiness and confusion can increase the risk of falling.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or other antihistamines (such as diphenhydramine, promethazine).Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.Do not use with any other antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray) because increased side effects may occur.Hydroxyzine is very similar to cetirizine and levocetirizine. Do not use these medications while using hydroxyzine.This medication may interfere with certain laboratory tests (including allergy skin testing, urine corticosteroids level), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, seizures. In children, mental/mood changes (such as restlessness, irritability) may occur before drowsiness.
NOTES: Do not share this medication with others.
MISSED DOSE: If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Do not freeze liquid forms of this medication. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised February 2022. Copyright(c) 2022 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
