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hydroxyzine (Atarax, Vistaril)
Tradenames:
-> Atarax (hydroxyzine HCl), Vistaril (hydroxyzine pamoate).
Indications:
- sedation [4]
- symptomatic relief of anxiety or tension
- pruritus caused by allergic conditions
- urticaria [4]
- insomnia
- agitation caused by alcohol withdrawal
- control of nausea/vomiting
- used in conjunction with opiates for additive analgesia
- prevention of motion sickness
Contraindications: Caution:
1) narrow-angle glaucoma
2) prostatic hypertrophy
3) bladder neck obstruction
4) avoid in early pregnancy
Dosage:
1) 0.5 mg/kg up to 25-100 mg PO/IM* every 4-6 hours PRN (pamoate).
2) 10-20 mg every 4-6 hours (HCl {Atarax})
Tabs: 10, 25, 50, 100 mg (pamoate). 10 mg, 20 mg (HCl)
Suspension: 10 & 25 mg/5 mL.
Injection: 25 mg/mL (1 mL); 50 mg/mL (1 mL, 2 mL, 10 mL) *Do not give IV or SC; thrombosis & digital gangrene may occur.
Pharmacokinetics:
1) rapidly absorbed from GI tract after oral administration
2) onset of sedative effect occurs within 15-30 minutes
3) effects persist for 4-6 hours after a single oral dose
4) metabolized by liver
Adverse effects:
1) common (> 10%)
- drowsiness (slight to moderate)
- thickening of bronchial secretions
2) less common (1-10%)
- headache, fatigue, increased appetite, weight gain, nervousness, dizziness, nausea, diarrhea, abdominal pain, dry mouth, pharyngitis, arthralgia
3) uncommon (< 1%)
- angioedema, bronchospasm, depression, edema, epistaxis, hepatitis, myalgia, palpitations, paresthesia, photosensitivity, rash, hypotension, sedation, paradoxical excitement, insomnia, tremor, blurred vision, urinary retention
4) other [2]
- ataxia
Drug interactions:
1) additive effects with other CNS depressants
2) MAO inhibitors increase anticholinergic effects
3) hydroxyzine may block vasopressor effect of epinephrine
4) additive effects with other anticholinergic agents
Mechanism of action:
1) piperazine antihistamine, H1 receptor antagonist
2) anticholinergic agent
3) antispasmodic agent
4) local anesthetic
5) antimotion properties
Interactions
drug interactions
drug adverse effects (more general classes)
General
antipruritic agent
H1 receptor antagonist (antihistamine)
piperazine
sedative/hypnotic (tranquilizer)
Properties
MISC-INFO: elimination route LIVER
pregnancy-category C
safety in lactation -
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
- Deprecated Reference
Component-of
ephedrine/hydroxyzine/theophylline
hydroxyzine/labetalol