Hydroxyzine


Generic Medicine Info
Administration
Hydroxyzine: May be taken with or without food.
Contraindications
Acquired or congenital QT interval prolongation, predisposition to QT interval prolongation and torsade de pointes such as significant electrolyte imbalance (e.g. hypokalaemia, hypomagnesaemia), significant bradycardia, history of cardiac arrhythmia, family history of sudden cardiac death; porphyria. Asthmatic patients with previous serious antihistamine-induced adverse bronchopulmonary effect. Severe liver disease. Pregnancy and lactation. Concomitant use of drugs known to prolong QT interval or induce torsade de pointes (e.g. quinidine, amiodarone).
Special Precautions
Patient with increased intraocular pressure, angle-closure glaucoma, emphysema, chronic bronchitis, asthma, COPD, decreased gastrointestinal motility, stenosing peptic ulcer, pyloroduodenal obstruction, primary biliary cirrhosis, bladder outflow obstruction, urinary retention, prostatic hyperplasia, hyperthyroidism, recent MI, uncompensated heart failure, CV disease, hypertension, myasthenia gravis, dementia, epilepsy; increased potential for convulsions. Patients taking drugs that induce bradycardia and hypokalaemia. Renal and hepatic impairment. Children and elderly. Patient Counselling This drug may cause dizziness, drowsiness and reduced physical coordination, if affected, do not drive or operate machinery. Monitoring Parameters Monitor blood pressure, mental status, and signs of symptom relief.
Adverse Reactions
Significant: CNS depression, tachycardia, palpitation, bronchospasm, extrapyramidal effects, tremor, convulsion, severe injection site reactions (e.g. extensive tissue damage, necrosis, gangrene) with IM administration. Rarely, acute generalised exanthematous pustulosis. Blood and lymphatic system disorders:Agranulocytosis, leucopenia, thrombocytopenia, haemolytic anaemia. Ear and labyrinth disorders: Tinnitus, labrynthitis, vertigo. Eye disorders: Blurred vision, accommodation disorder. Gastrointestinal disorders: Dry mouth, constipation, nausea, vomiting, epigastric pain. General disorders and administration site conditions: Fatigue, asthenia, malaise, pyrexia. Immune system disorders: Urticaria, anaphylaxis, angioedema. Investigations: Abnormal LFTs. Metabolism and nutrition disorders: Porphyria, anorexia. Musculoskeletal and connective tissue disorders: Myalgia. Nervous system disorders: Somnolence, headache, dizziness, paraesthesia, dyskinesia. Psychiatric disorders: Insomnia, hallucination, sleep disturbances, slurred speech. Renal and urinary disorders: Urinary retention, dysuria. Reproductive system and breast disorders: Priapism, impotence. Respiratory, thoracic and mediastinal disorders: Thickened respiratory secretion, wheezing, nasal stuffiness. Skin and subcutaneous tissue disorders: Rash, pruritus, alopecia, fixed drug eruption. Vascular disorders: Hypotension, flushing.
Potentially Fatal: Torsade de pointes, QT interval prolongation, cardiac arrhythmia, respiratory depression; intravascular haemolysis, thrombosis, and digital gangrene following IV or intra-arterial inj.
X in 1st trimester
Drug Interactions
May potentiate the CNS depressant effects of opiates (e.g. meperidine) and other analgesics; barbiturates, benzodiazepines, hypnotics, anxiolytics, antiemetics, antiepileptics, other antihistamines, skeletal muscle relaxants, sedatives, anaesthetics. Potentiate antimuscarinic effects of TCAs, MAOIs, and other anticholinergics (e.g. atropine). Increased plasma concentrations with cimetidine, potent CYP3A4, CYP3A5 and alcohol dehydrogenase inhibitors. Inhibits and reverses the vasopressor effect of epinephrine. May antagonise the effects of betahistine and anticholinesterase drugs. May mask the signs of damage caused by ototoxic agents (e.g. aminoglycosides).
CIMS Class
Antihistamines & Antiallergics / Anxiolytics
ATC Classification
N05BB01 - hydroxyzine ; Belongs to the class of diphenylmethane derivatives anxiolytics. Used in the management of anxiety, agitation or tension.
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