Hydroxyzine

Brand Names: Atarax

Drug Class: First-generation antihistamine, Piperazine derivative

Overview

Hydroxyzine is a first-generation antihistamine with sedative, anxiolytic, antiemetic, and anticholinergic properties. It is commonly used for anxiety, pruritus, and as a preoperative sedative.

Mechanism of Action

Acts as a histamine H1 receptor antagonist and also exhibits anticholinergic, anxiolytic, and sedative effects through central nervous system depression.

Indications

  • Anxiety and tension
  • Pruritus due to allergic conditions
  • Preoperative sedation
  • Nausea and vomiting

Dosage

Adults: 25-100 mg orally 3-4 times daily. Children >6 years: 50-100 mg/day in divided doses. Adjust based on indication and patient response.

Contraindications

  • Hypersensitivity to hydroxyzine or components
  • Early pregnancy
  • Breastfeeding
  • Patients with prolonged QT interval

Side Effects

  • Drowsiness
  • Dry mouth
  • Headache
  • Dizziness
  • Blurred vision
  • Constipation
  • Tachycardia

Interactions

  • CNS depressants (alcohol, opioids, benzodiazepines)
  • Anticholinergic drugs
  • QT-prolonging agents
  • Monoamine oxidase inhibitors (MAOIs)