Dosing & Uses

AdultPediatricGeriatric

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

0.6 mg/kg PO  

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

Next:

Interactions

Interaction Checker

and hydroxyzine

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      Serious - Use Alternative

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             activity indicator 

            Contraindicated (2)

            • dronedarone

              hydroxyzine and dronedarone both increase QTc interval. Contraindicated.

            • thioridazine

              hydroxyzine and thioridazine both increase QTc interval. Contraindicated.

            Serious - Use Alternative (73)

            • 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.

            • 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 (260)

            • 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.

            • 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.

            • 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.

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            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

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            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)
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            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.

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            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

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            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

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            Images

            BRAND FORM. UNIT PRICE PILL IMAGE
            hydroxyzine HCl oral
            -
            25 mg tablet
            hydroxyzine HCl oral
            -
            10 mg tablet
            hydroxyzine HCl oral
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            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
            -
            50 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
            -
            25 mg tablet
            hydroxyzine HCl oral
            -
            50 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
            -
            50 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 oral
            -
            10 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

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            Patient Handout

            Select a drug:
            Patient Education
            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.

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            Formulary

            FormularyPatient Discounts

            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.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.