Skip to content

Hydroxyzine

    Brands

    DEA Class; Rx

    Common Brand Names; Vistaril

    • Antiemetic Agents; 
    • Antihistamines, 1st Generation; 
    • Antihistamines, Piperazine Derivatives

    Oral and parenteral sedating antihistamine of the piperazine class
    Used commonly for histamine-mediated pruritus due to atopy or for treating other allergic conditions
    Sometimes used perioperatively as a sedative/anxiolytic and antiemetic

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

    For the treatment of pruritus due allergic conditions, such as chronic urticaria (e.g., chronic idiopathic urticaria), atopic dermatitis, or contact dermatitis, and histamine-mediated pruritus.
    For the treatment of nausea/vomiting, excluding the nausea and vomiting of pregnancy.
    For post-operative nausea/vomiting (PONV) and post-operative nausea/vomiting (PONV) prophylaxis.
    For procedural sedation including as an adjunctive therapy to reduce anxiety and narcotic dosage pre- and postoperative or pre- and postpartum.
    For the short term treatment of insomnia.
     

    Documented hypersensitivity or related product including cetirizine and levocetirizine and components of the formulation

    Prolonged QT interval

    SC, intra-arterial, or IV administration

    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

    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

    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

    Adults

    400 mg/day PO; 600 mg/day IM.

    Geriatric

    400 mg/day PO; 600 mg/day IM.

    Adolescents

    100 mg/day PO for pruritus and anxiety; 0.6 mg/kg (Max: 100 mg) PO once for procedural sedation; 1.1 mg/kg (Max: 100 mg) IM once for nausea, vomiting, or procedural sedation.

    Children

    6 to 12 years: 100 mg/day PO for pruritus and anxiety; 0.6 mg/kg (Max: 100 mg) PO once for procedural sedation; 1.1 mg/kg (Max: 100 mg) IM once for nausea, vomiting, or procedural sedation.
    1 to 5 years: 50 mg/day PO or 2 mg/kg/day PO (in patients weighing 40 kg or less) for pruritus and anxiety; 0.6 mg/kg (Max: 100 mg) PO once for procedural sedation; 1.1 mg/kg (Max: 100 mg) IM once for nausea, vomiting, or procedural sedation.

    Infants

    Safety and efficacy have not been established.

    Neonates

    Safety and efficacy have not been established.

    Hydroxyzine hydrochloride

    tablet

    • 10mg
    • 25mg
    • 50mg

    capsule

    • 25mg
    • 50mg
    • 100mg

    syrup/oral suspension

    • 10mg/5mL

    injectable solution

    • 25mg/mL
    • 50mg/mL