Classes
DEA Class; Rx
Common Brand Names; Vistaril
- Antiemetic Agents;
- Antihistamines, 1st Generation;
- Antihistamines, Piperazine Derivatives
Description
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
Indications
Indicated for the short-term treatment of anxiety, tension, and psychomotor agitation in conditions of emotional stress.
Contraindications
Documented hypersensitivity or related product including cetirizine and levocetirizine and components of the formulation
Prolonged QT interval
SC, intra-arterial, or IV administration
Adverse Effects
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
Warnings
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 and 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
Maximum Dosage
400 mg/day PO; 600 mg/day IM.
400 mg/day PO; 600 mg/day IM.
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.
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.
Safety and efficacy have not been established.
Safety and efficacy have not been established.
How supplied
Hydroxyzine hydrochloride
tablet
- 10mg
- 25mg
- 50mg
capsule
- 25mg
- 50mg
- 100mg
syrup/oral suspension
- 10mg/5mL
injectable solution
- 25mg/mL
- 50mg/mL
