Hydroxyzine with benadryl
Hydroxyzine - Minded
What is hydroxyzine?
Hydroxyzine is a prescription antihistamine that is used to treat anxiety and insomnia.
Antihistamines—including hydroxyzine—work by decreasing the effects of histamine. Histamine is a chemical in your body that produces an allergic reaction.
Even though many antihistamines are available over-the-counter (meaning you can purchase them without a prescription), hydroxyzine is a prescription medication.
This Minded Medication Guide will take a closer look at hydroxyzine to help you when talking with your doctor, prescribing nurse, or Minded provider to choose the right medication for your treatment plan.
In addition to being an antihistamine, hydroxyzine is also a serotonin antagonist, meaning it works in a way that is similar to selective serotonin reuptake inhibitors (SSRIs), which are another type of medication that can be used to treat anxiety. Serotonin is a neurotransmitter that helps balance your mood and impacts feelings of optimism, satisfaction, contentment, and overall well-being. Hydroxyzine increases the amount of serotonin in your brain by stopping it from being reabsorbed into the neurons (nerves in your brain).
When taken for anxiety, the hydroxyzine dosage is usually divided into multiple doses per day. Adults typically take 50 to 100 mg, four times per day, though some people might need higher doses for symptom relief. The maximum recommended dose for children under the age of 6 is no more than 50 mg daily (taken divided into smaller doses).
While you can take hydroxyzine with or without food, if you find that taking it without food upsets your stomach, you may want to try taking it with food. Hydroxyzine can be taken daily at regularly scheduled times or as-needed. Your doctor, prescribing nurse, or Minded professional will provide you with information on when and how frequently to take this medication—and the maximum amount that can be taken in a day.
Hydroxyzine is sometimes also prescribed to help with difficulty sleeping or insomnia. Just as other antihistamines—such as Benadryl—may make you feel drowsy when you take them, hydroxyzine works in the same way.
While the recommended hydroxyzine dosage for sleep will vary depending on your age and how your body reacts to the medication, the typical adult dose ranges from 25 to 100 mg. This should be taken before bed and can be taken with or without food. Your doctor, prescribing nurse, or Minded professional will work with you to determine the right dose for your needs.
Hydroxyzine for allergies
Because it is an antihistamine—like Benadryl—hydroxyzine is sometimes prescribed to relieve symptoms of allergic reactions. However, hydroxyzine and Benadryl should not be used together.
Hydroxyzine typically helps with skin-related symptoms of an allergic reaction, such as itching or hives. Benadryl, on the other hand, usually helps with red/watery eyes, sneezing, and runny noses.
Hydroxyzine side effects, warnings, and interactions
Hydroxyzine side effects
Common side effects of hydroxyzine include:
- Blurred vision
- Dry mouth
- Urinary retention (when your bladder does not empty all the way)
Talk to your doctor or the experts at Minded if you experience any of these or other side effects.
Rare or serious side effects of hydroxyzine include:
- Allergic reaction to the medication, even though the medication generally is taken to reduce allergic reactions (symptoms of which could include: difficulty breathing; hives; and swelling in your lips, tongue, or face)
- Increased heart rate and/or abnormal heartbeat
- Priapism (an erection lasting longer than 4 hours)
- Skin rash (called acute generalized exanthematous pustulosis, or AGEP)
Seek medical attention right away if you experience any of these (or other) serious side effects.
Hydroxyzine and blood pressure
In some cases, hydroxyzine can cause low blood pressure. While this side effect was not noted during initial clinical trials before it was approved by the FDA, it has been reported since.
Hydroxyzine and alcohol
You should not drink alcohol while taking hydroxyzine. As with many medications, alcohol can increase the negative side effects—such as sedation—and decrease the benefits. Alcohol can also impair both judgment and memory, which can result in an accidental overdose if you unknowingly take a higher dose of hydroxyzine than what is prescribed.
Symptoms of a hydroxyzine overdose include:
- Decreased coordination
- Difficulty urinating
- Dry mouth
- Rapid heartbeat
- Slowed reflexes
Hydroxyzine and pregnancy
If you are pregnant or planning on becoming pregnant, it is important that you discuss your anxiety or insomnia treatment plan with your doctor. Typically, hydroxyzine should not be taken during the first trimester of pregnancy or right before or during labor. However, it can be taken during the second and third trimesters.
Taking hydroxyzine while breastfeeding is not recommended. This is because the medication may be passed to your baby through breast milk.
Hydroxyzine vs. Benadryl For Sleep
Written by Juhi Modi
Medically reviewed by HaVy Ngo-Hamilton, Pharm.D. | Apr 25, 2022
Antihistamines are drugs that are commonly used to treat allergic reactions and allergy symptoms. These medications are available both by prescription and over-the-counter. Like all medicines, they can cause side effects. One of the common adverse effects of antihistamines is drowsiness. While this side effect is unwanted during the day, it can be desirable at night for someone suffering from insomnia or sleeplessness.
Please continue reading to learn more about using an antihistamine as a sleep aid. To find out which one is better for sleep, we will talk about two antihistamines in particular — Hydroxyzine and Benadryl. We’ll also discuss whether it is safe to take antihistamines to treat chronic insomnia (long-term sleep problems) and other sleep disorders.Is Benadryl the same as hydroxyzine?
Hydroxyzine is a prescription antihistamine used to treat itching and other symptoms of allergic reactions on the skin, such as contact dermatitis and hives. It has sedative properties and can cause drowsiness as a side effect. Doctors believe this occurs because hydroxyzine lowers the levels of a chemical called histamine in the body. Studies have shown that histamine release is highest during waking; therefore, blocking histamine will cause sedation.
Because of hydroxyzine's calming effects due to its unique effects on serotonin, hydroxyzine is also prescribed to treat anxiety disorders like generalized anxiety disorder (GAD), panic disorder, tension, and sleep problems.
Benadryl is the brand name of the generic medication diphenhydramine. It is an over-the-counter antihistamine used to treat allergies, hay fever, and symptoms of allergic reactions such as rash, hives, itching, runny nose, and watery eyes. It is also used to relieve motion sickness.
Benadryl's sedating effect makes it a useful drug for insomnia and other sleep problems. In addition, Benadryl is also used to manage some symptoms of Parkinson's disease.Can hydroxyzine be used as a sleep aid?
Hydroxyzine is a prescription medication available under two brand names — Atarax (hydroxyzine hydrochloride) and Vistaril (hydroxyzine pamoate). Atarax and Vistaril are the same medications with different salts. It is commonly believed that Vistaril is better for sleep and anxiety, while Atarax works well for itch and hives. However, there is no evidence suggesting that one salt has advantages over the other. Often, it will come to "trial and error" to determine which product works best for your condition.
Hydroxyzine may not be the right choice to treat insomnia in every patient. For example, it may not be the right option for geriatric patients because of the possible side effects that can lead to an increased risk of falls and injuries.
As mentioned, hydroxyzine is a prescription medication; self-medication with hydroxyzine to treat insomnia is firmly not recommended. It is important to discuss the pros and cons of taking hydroxyzine as a sleep aid with a healthcare provider.What is better - Benadryl or hydroxyzine?
Your healthcare professional is the best person to help you decide between hydroxyzine vs. Benadryl as a sleep aid. Both medications are generally safe and effective, but one may be better for you based on your other medical conditions and concurrent medicines.
Additionally, your doctor might refer you to a sleep medicine specialist who can check for other sleep disorders such as obstructive sleep apnea and circadian rhythm disorders as the underlying cause of your insomnia.Which antihistamine is best for sleep?
Antihistamines like hydroxyzine and Benadryl can cause you to feel drowsy; therefore, they are helpful as sleep aids. However, these drugs can have anticholinergic side effects such as dry mouth, drowsiness, blurred vision, and urinary retention. Besides the common side effects, hydroxyzine and Benadryl have their own serious side effect profiles. For example, Benadryl can cause enlarged prostate and heart rhythm problems, while hydroxyzine is responsible for restless muscle movement and seizures. Remember that hydroxyzine will require a prescription while Benadryl is available over-the-counter.
Research suggests that Benadryl is better than other antihistamines, including hydroxyzine, in treating allergies. Benadryl also causes more drowsiness compared to other over-the-counter medications to treat allergies.
Besides hydroxyzine and Benadryl, there are other effective OTC sleep aids, such as doxylamine succinate (Unisom SleepTabs), a sedating antihistamine. Some prescription medications are also used off-label for insomnia. For example, antidepressants like trazodone and amitriptyline, or nerve pain medication like gabapentin, also treat sleep problems.
Your doctor might recommend one of the above agents or suggest you take an over-the-counter supplement such as melatonin, depending on the underlying cause of your insomnia. Most patients with mild cases of insomnia can benefit from non-medication approaches such as cognitive-behavioral therapy (CBT) and good sleep hygiene to restore the natural sleep-wake cycle.Is it safe to take an antihistamine for sleep every night?
It is not recommended to take antihistamines long-term as sleep aids due to their serious side effect profiles with no concrete evidence of their effectiveness in treating insomnia long-term. There are better alternatives available.
Also, you should know that using hydroxyzine or other antihistamines as sleeping pills due to their sedative properties is only a short-term solution. These medicines can cause daytime drowsiness and potentially harmful adverse reactions. Also, there can be drug interactions between antihistamines and other medicines or other substances in dietary supplements. Stopping antihistamine use after taking them for a long time can lead to withdrawal symptoms. Another important fact is that you can develop a tolerance to the sedative effects of antihistamines — so when you take them for an extended period, they become less effective to make you sleepy. Finally, research suggests that long-term sleep aid use can lower the overall sleep quality.What are some precautions while taking antihistamines for sleep disorders like insomnia?
Always consult a doctor or a pharmacist before taking an antihistamine as a sleep aid. Antihistamines may not be appropriate for people with certain medical conditions, pregnant or breastfeeding women, and older adults.
Do not drink alcohol while taking sleep aids, as this can result in more severe side effects. Also, beware of daytime sleepiness and don’t drive or do activities that require focus until you know how these medicines affect you.
Remember, sleep aids are a temporary solution and should not generally be used for longer than two weeks.Sleep aids are not a magic cure
The inability to fall asleep, stay asleep, or have poor sleep quality can negatively impact your health, mood, productivity, and overall quality of life. Many people turn to over-the-counter sleep aids, including antihistamines with sedative properties, to get much-needed restful sleep.
It is important to understand that prescription or over-the-counter drugs may be an effective solution for an occasional sleepless night, but they are not a magic cure. You should not take these medications long-term without being advised by a healthcare professional.
If you continue to have trouble sleeping, talk to your doctor about lifestyle changes, behavior therapy, sleep hygiene, and different pharmacological agents that are the most suitable for your health history and preference.
ANTIHISTAMINS: from diphenhydramine to telfast | #03/01
Historically, the term "antihistamines" means drugs that block H1-histamine receptors, and drugs that act on H2-histamine receptors (cimetidine, ranitidine, famotidine, etc.) are called H2-histamine blockers. The former are used to treat allergic diseases, the latter are used as antisecretory agents.
Histamine, this most important mediator of various physiological and pathological processes in the body, was chemically synthesized in 1907 year. Subsequently, it was isolated from animal and human tissues (Windaus A., Vogt W.). Even later, its functions were determined: gastric secretion, neurotransmitter function in the central nervous system, allergic reactions, inflammation, etc. Almost 20 years later, in 1936, the first substances with antihistamine activity were created (Bovet D., Staub A.). And already in the 60s, the heterogeneity of histamine receptors in the body was proven and three of their subtypes were identified: H1, H2 and H3, differing in structure, localization and physiological effects that occur during their activation and blockade. Since that time, an active period of synthesis and clinical testing of various antihistamines begins. nine0003
Numerous studies have shown that histamine, acting on the receptors of the respiratory system, eyes and skin, causes characteristic allergy symptoms, and antihistamines that selectively block H1-type receptors can prevent and stop them.
Most of the antihistamines used have a number of specific pharmacological properties that characterize them as a separate group. These include the following effects: antipruritic, decongestant, antispastic, anticholinergic, antiserotonin, sedative and local anesthetic, as well as the prevention of histamine-induced bronchospasm. Some of them are not due to histamine blockade, but to structural features. nine0003
Antihistamines block the action of histamine on H1 receptors by the mechanism of competitive inhibition, and their affinity for these receptors is much lower than that of histamine. Therefore, these drugs are not able to displace histamine bound to the receptor, they only block unoccupied or released receptors. Accordingly, H1 blockers are most effective in preventing immediate allergic reactions, and in the case of a developed reaction, they prevent the release of new portions of histamine. nine0003
According to their chemical structure, most of them are fat-soluble amines, which have a similar structure. The core (R1) is represented by an aromatic and/or heterocyclic group and is linked via a nitrogen, oxygen or carbon (X) molecule to the amino group. The core determines the severity of antihistamine activity and some of the properties of the substance. Knowing its composition, one can predict the strength of the drug and its effects, such as the ability to penetrate the blood-brain barrier. nine0003
There are several classifications of antihistamines, although none of them is generally accepted. According to one of the most popular classifications, antihistamines are divided into first and second generation drugs according to the time of creation. First-generation drugs are also called sedatives (according to the dominant side effect), in contrast to non-sedative second-generation drugs. At present, it is customary to isolate the third generation: it includes fundamentally new drugs - active metabolites that, in addition to the highest antihistamine activity, exhibit the absence of a sedative effect and the cardiotoxic effect characteristic of second-generation drugs (see table). nine0003
In addition, according to the chemical structure (depending on the X-bond), antihistamines are divided into several groups (ethanolamines, ethylenediamines, alkylamines, derivatives of alphacarboline, quinuclidine, phenothiazine, piperazine and piperidine).
First generation antihistamines (sedatives). All of them are well soluble in fats and, in addition to H1-histamine, also block cholinergic, muscarinic and serotonin receptors. Being competitive blockers, they reversibly bind to H1 receptors, which leads to the use of rather high doses. The following pharmacological properties are most characteristic of them. nine0003
- Sedative effect is determined by the fact that most of the first generation antihistamines, being easily dissolved in lipids, penetrate well through the blood-brain barrier and bind to the H1-receptors of the brain. Perhaps their sedative effect consists of blocking the central serotonin and acetylcholine receptors. The degree of manifestation of the sedative effect of the first generation varies in different drugs and in different patients from moderate to severe and increases when combined with alcohol and psychotropic drugs. Some of them are used as sleeping pills (doxylamine). Rarely, instead of sedation, psychomotor agitation occurs (more often in medium therapeutic doses in children and in high toxic doses in adults). Due to the sedative effect, most drugs should not be used during tasks that require attention. All first-generation drugs potentiate the action of sedative and hypnotic drugs, narcotic and non-narcotic analgesics, monoamine oxidase inhibitors and alcohol. nine0024
- The anxiolytic effect characteristic of hydroxyzine may be due to the suppression of activity in certain areas of the subcortical region of the CNS.
- Atropine-like reactions associated with the anticholinergic properties of drugs are most characteristic of ethanolamines and ethylenediamines. Manifested by dry mouth and nasopharynx, urinary retention, constipation, tachycardia and visual impairment. These properties ensure the effectiveness of the discussed remedies in non-allergic rhinitis. At the same time, they can increase obstruction in bronchial asthma (due to an increase in sputum viscosity), exacerbate glaucoma and lead to infravesical obstruction in prostate adenoma, etc.
- Antiemetic and antiswaying effects are also likely to be associated with the central anticholinergic effect of the drugs. Some antihistamines (diphenhydramine, promethazine, cyclizine, meclizine) reduce the stimulation of vestibular receptors and inhibit the function of the labyrinth, and therefore can be used for motion sickness.
- A number of H1-histamine blockers reduce the symptoms of parkinsonism, which is due to the central inhibition of the effects of acetylcholine. nine0024
- Antitussive action is most characteristic of diphenhydramine, it is realized through a direct action on the cough center in the medulla oblongata.
- The antiserotonin effect, which is primarily characteristic of cyproheptadine, determines its use in migraine.
- α1-blocking effect with peripheral vasodilation, especially inherent in phenothiazine antihistamines, can lead to a transient decrease in blood pressure in sensitive individuals. nine0024
- Local anesthetic (cocaine-like) action is characteristic of most antihistamines (due to a decrease in membrane permeability to sodium ions). Diphenhydramine and promethazine are stronger local anesthetics than novocaine. However, they have systemic quinidine-like effects, manifested by prolongation of the refractory phase and the development of ventricular tachycardia.
- Tachyphylaxis: decrease in antihistamine activity with long-term use, confirming the need for alternating drugs every 2-3 weeks. nine0024
- It should be noted that first-generation antihistamines differ from second-generation antihistamines in the short duration of exposure with a relatively rapid onset of clinical effect. Many of them are available in parenteral forms. All of the above, as well as low cost, determine the widespread use of antihistamines today.
Moreover, many of the qualities that were discussed allowed the “old” antihistamines to occupy their niche in the treatment of certain pathologies (migraine, sleep disorders, extrapyramidal disorders, anxiety, motion sickness, etc.) that are not associated with allergies. Many first-generation antihistamines are included in combination preparations used for colds, as sedatives, hypnotics, and other components. nine0003
The most commonly used are chloropyramine, diphenhydramine, clemastine, cyproheptadine, promethazine, phencarol, and hydroxyzine.
Chloropyramine (Suprastin) is one of the most widely used sedative antihistamines. It has significant antihistamine activity, peripheral anticholinergic and moderate antispasmodic action. Effective in most cases for the treatment of seasonal and year-round allergic rhinoconjunctivitis, angioedema, urticaria, atopic dermatitis, eczema, itching of various etiologies; in parenteral form - for the treatment of acute allergic conditions requiring emergency care. Provides a wide range of usable therapeutic doses. It does not accumulate in the blood serum, so it does not cause an overdose with prolonged use. Suprastin is characterized by a rapid onset of effect and short duration (including side effects). At the same time, chloropyramine can be combined with non-sedating H1-blockers in order to increase the duration of the antiallergic effect. Suprastin is currently one of the best-selling antihistamines in Russia. This is objectively related to the proven high efficiency, controllability of its clinical effect, the availability of various dosage forms, including injections, and low cost. nine0003
Diphenhydramine , best known in our country under the name diphenhydramine, is one of the first synthesized H1-blockers. It has a fairly high antihistamine activity and reduces the severity of allergic and pseudo-allergic reactions. Due to the significant anticholinergic effect, it has an antitussive, antiemetic effect and at the same time causes dry mucous membranes, urinary retention. Due to lipophilicity, diphenhydramine gives pronounced sedation and can be used as a hypnotic. It has a significant local anesthetic effect, as a result of which it is sometimes used as an alternative for intolerance to novocaine and lidocaine. Diphenhydramine is presented in various dosage forms, including for parenteral use, which determined its widespread use in emergency therapy. However, a significant range of side effects, unpredictability of consequences and effects on the central nervous system require increased attention in its application and, if possible, the use of alternative means. nine0003
Clemastine (tavegil) is a highly effective antihistamine similar in action to diphenhydramine. It has a high anticholinergic activity, but to a lesser extent penetrates the blood-brain barrier. It also exists in an injectable form, which can be used as an additional remedy for anaphylactic shock and angioedema, for the prevention and treatment of allergic and pseudo-allergic reactions. However, hypersensitivity to clemastine and other antihistamines with a similar chemical structure is known. nine0003
Cyproheptadine (peritol), along with antihistamine, has a significant antiserotonin effect. In this regard, it is mainly used in some forms of migraine, dumping syndrome, as an appetite enhancer, in anorexia of various origins. It is the drug of choice for cold urticaria.
Promethazine (pipolfen) - a pronounced effect on the central nervous system determined its use in Meniere's syndrome, chorea, encephalitis, sea and air sickness, as an antiemetic. In anesthesiology, promethazine is used as a component of lytic mixtures to potentiate anesthesia. nine0003
Quifenadine (phencarol) - has less antihistamine activity than diphenhydramine, but is also characterized by less penetration through the blood-brain barrier, which determines the lower severity of its sedative properties. In addition, fenkarol not only blocks histamine H1 receptors, but also reduces the content of histamine in tissues. May be used in the development of tolerance to other sedative antihistamines.
nine0019 Hydroxyzine (atarax) - despite the existing antihistamine activity, it is not used as an antiallergic agent. It is used as an anxiolytic, sedative, muscle relaxant and antipruritic agent.
Thus, first-generation antihistamines that affect both H1- and other receptors (serotonin, central and peripheral cholinergic receptors, a-adrenergic receptors) have different effects, which determined their use in a variety of conditions. But the severity of side effects does not allow us to consider them as drugs of first choice in the treatment of allergic diseases. The experience gained with their use has allowed the development of unidirectional drugs - the second generation of antihistamines. nine0003
Second generation antihistamines (non-sedating). Unlike the previous generation, they almost do not have sedative and anticholinergic effects, but differ in their selective action on H1 receptors. However, for them, a cardiotoxic effect was noted to varying degrees.
The following properties are the most common for them.
- High specificity and high affinity for H1 receptors with no effect on choline and serotonin receptors. nine0024
- Rapid onset of clinical effect and duration of action. Prolongation can be achieved due to high protein binding, accumulation of the drug and its metabolites in the body, and delayed elimination.
- Minimal sedation when using drugs at therapeutic doses. It is explained by the weak passage of the blood-brain barrier due to the peculiarities of the structure of these funds. Some particularly sensitive individuals may experience moderate drowsiness, which is rarely the reason for discontinuing the drug. nine0024
- No tachyphylaxis with long-term use.
- The ability to block the potassium channels of the heart muscle, which is associated with prolongation of the QT interval and cardiac arrhythmias. The risk of this side effect increases when antihistamines are combined with antifungals (ketoconazole and itraconazole), macrolides (erythromycin and clarithromycin), antidepressants (fluoxetine, sertraline and paroxetine), grapefruit juice, and in patients with severe liver dysfunction. nine0024
- No parenteral formulations, but some (azelastine, levocabastine, bamipine) are available as topical formulations.
Below are second-generation antihistamines with their most characteristic properties.
Terfenadine is the first antihistamine drug without CNS depressant action. Its creation in 1977 was the result of a study of both the types of histamine receptors and the features of the structure and action of existing H1-blockers, and laid the foundation for the development of a new generation of antihistamines. Currently, terfenadine is used less and less, which is associated with its increased ability to cause fatal arrhythmias associated with prolongation of the QT interval (torsade de pointes). nine0003
Astemizol is one of the longest-acting drugs of the group (the half-life of its active metabolite is up to 20 days). It is characterized by irreversible binding to H1 receptors. Virtually no sedative effect, does not interact with alcohol. Since astemizole has a delayed effect on the course of the disease, it is not advisable to use it in an acute process, but it may be justified in chronic allergic diseases. Since the drug has the ability to accumulate in the body, the risk of developing serious heart rhythm disturbances, sometimes fatal, increases. Due to these dangerous side effects, the sale of astemizole in the United States and some other countries has been suspended. nine0003
Acrivastine (semprex) is a drug with high antihistamine activity with minimal sedative and anticholinergic effects. A feature of its pharmacokinetics is a low level of metabolism and the absence of cumulation. Acrivastine is preferred in cases where there is no need for permanent antiallergic treatment due to the rapid onset of effect and short-term effect, which allows for a flexible dosing regimen.
nine0019 Dimetendene (Fenistil) is the closest to the first generation antihistamines, but differs from them in a significantly less pronounced sedative and muscarinic effect, higher antiallergic activity and duration of action.
Loratadin (Claritin) is one of the most purchased second-generation drugs, which is quite understandable and logical. Its antihistamine activity is higher than that of astemizole and terfenadine, due to the greater strength of binding to peripheral H1 receptors. The drug is devoid of a sedative effect and does not potentiate the effect of alcohol. In addition, loratadine practically does not interact with other drugs and does not have a cardiotoxic effect. nine0003
The following antihistamines are topical preparations and are intended to relieve local manifestations of allergies.
Levocabastin (Histimet) is used as an eye drop for the treatment of histamine-dependent allergic conjunctivitis or as a spray for allergic rhinitis. When applied topically, it enters the systemic circulation in a small amount and does not have undesirable effects on the central nervous and cardiovascular systems. nine0003
Azelastine (Allergodil) is a highly effective treatment for allergic rhinitis and conjunctivitis. Used as a nasal spray and eye drops, azelastine has little to no systemic effects.
Another topical antihistamine, bamipine (soventol), in the form of a gel, is intended for use in allergic skin lesions accompanied by itching, insect bites, jellyfish burns, frostbite, sunburn, and mild thermal burns. nine0003
Third generation antihistamines (metabolites). Their fundamental difference is that they are active metabolites of antihistamines of the previous generation. Their main feature is the inability to influence the QT interval. Currently, there are two drugs - cetirizine and fexofenadine.
Cetirizine (Zyrtec) is a highly selective peripheral H1 receptor antagonist. It is an active metabolite of hydroxyzine, which has a much less pronounced sedative effect. Cetirizine is almost not metabolized in the body, and the rate of its excretion depends on the function of the kidneys. Its characteristic feature is its high ability to penetrate the skin and, accordingly, its effectiveness in skin manifestations of allergies. Cetirizine neither experimentally nor in the clinic showed any arrhythmogenic effect on the heart, which predetermined the area of practical use of metabolite drugs and determined the creation of a new drug, fexofenadine. nine0003
Fexofenadine (telfast) is the active metabolite of terfenadine. Fexofenadine does not undergo transformations in the body and its kinetics does not change with impaired liver and kidney function. It does not enter into any drug interactions, does not have a sedative effect and does not affect psychomotor activity. In this regard, the drug is approved for use by persons whose activities require increased attention. A study of the effect of fexofenadine on the QT value showed, both in the experiment and in the clinic, the complete absence of a cardiotropic effect when using high doses and with long-term use. Along with maximum safety, this remedy demonstrates the ability to stop symptoms in the treatment of seasonal allergic rhinitis and chronic idiopathic urticaria. Thus, the pharmacokinetics, safety profile and high clinical efficacy make fexofenadine the most promising of the antihistamines at present. nine0003
So, in the doctor's arsenal there is a sufficient amount of antihistamines with different properties. It must be remembered that they provide only symptomatic relief from allergies. In addition, depending on the specific situation, you can use both different drugs and their diverse forms. It is also important for the physician to be aware of the safety of antihistamines.
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All about Hydroxyzine Oral Tablet
What is Hydroxyzine Oral Tablet?
If you have anxiety, allergies, or scheduled surgery, your doctor may prescribe hydroxyzine for you.
This is a prescription medicine used in adults and some children to:
- to treat anxiety
- to treat itching
- to help induce sedation (a state of sleepiness and relaxation) before or after you receive anesthesia for surgery nine0024
To learn more about these conditions and how Hydroxyzine is used for them, see "What is Hydroxyzine Oral Tablet Used For?" section below.
Hydroxyzine Oral Tablet Base
Hydroxyzine is classified as an antihistamine.
You will be taking hydroxyzine oral tablets by mouth.
Hydroxyzine is also available as capsules, syrup and injection. Hydroxyzine hydrochloride is contained in oral tablets. Other types of hydroxyzine are found in other forms of the drug. This article only describes the oral tablet form. If you want to know about other forms of hydroxyzine, talk to your doctor or pharmacist. nine0003
Hydroxyzine oral tablet branded versions
Hydroxyzine oral tablet not available in branded version.
Hydroxyzine capsules are available as a brand name drug. To find out about this version of hydroxyzine, talk to your doctor or pharmacist.
Hydroxyzine oral tablet is a generic, which means it is an exact copy of the active drug in the brand-name drug. The branded drug that the hydroxyzine oral tablet is based on was called Atarax. But the branded Atarax is no longer available. nine0003
Generic drugs are considered to be as safe and effective as the brand name drugs they are based on. As a general rule, generics usually cost less than brand-name drugs.
Read this article on drinking to learn more about the differences between generic and brand name drugs.
What are the side effects of hydroxyzine oral tablet?
Like most medicines, hydroxyzine oral tablets can cause mild or serious side effects. The lists below describe some of the most common side effects that hydroxyzine oral tablets may cause. These lists do not include all possible side effects. nine0003
Be aware that the side effects of the drug may depend on:
- your prescribed dose
- your age
- other health conditions you may have
- other medicines you may be taking
Your doctor or pharmacist can tell you more about the potential side effects of hydroxyzine oral tablets. They may also suggest ways to reduce side effects.
Mild side effects
Here is a short list of some of the milder side effects that hydroxyzine oral tablets may cause. For other mild side effects, talk to your doctor or pharmacist, or read the prescribing information for hydroxyzine oral tablet.
Mild side effects of hydroxyzine oral tablets have been reported:
- dry mouth
- fatigue (lack of energy)
- Insomnia (problems with falling asleep or sleep)
- Low Blood pressure*
Light side effects of many drugs may disappear within a few days or a pair weeks. But if they become bothersome, talk to your doctor or pharmacist.
Serious side effects
Serious side effects from hydroxyzine oral tablets may occur but are not common. If you have serious side effects from hydroxyzine oral tablets, call your doctor right away. However, if you think you have a medical emergency, you should call 911 or your local emergency number.
Reported serious side effects of hydroxyzine oral tablets include:
- abnormal heart rhythm such as long QT syndrome and torsades de pointes
- skin reactions*
- allergic reactions
You may experience drowsiness while taking hydroxyzine oral tablets. This was a very common side effect reported in studies of the drug.
Because of the risk of drowsiness, you should avoid driving until you know how hydroxyzine oral tablets are affecting you.
Drowsiness from hydroxyzine oral tablets usually goes away after you take them for a few days. But if you have severe drowsiness or drowsiness that doesn't go away, let your doctor know. You may be given a lower dose of the drug. nine0003
Low blood pressure
You may get low blood pressure while taking hydroxyzine oral tablets.
This was not a side effect reported in drug studies. Instead, after initial studies of the drug, low blood pressure was reported due to hydroxyzine. Be aware, however, that low blood pressure is also a possible side effect of an overdose of hydroxyzine oral tablets. nine0003
Your risk of low blood pressure from hydroxyzine is higher if you have heart problems. It is also higher if you take antidepressants called monoamine oxidase inhibitors (MAOIs).
You may not have symptoms of low blood pressure unless your blood pressure is very low. Symptoms of extremely low blood pressure may include:
- blurred vision
- dizziness or lightheadedness
- fatigue (lack of energy)
Before you start taking hydroxyzine oral tablets, tell your doctor about all your health conditions and any medications you are taking.
Call your doctor right away if you have symptoms of extremely low blood pressure while you are taking hydroxyzine oral tablets.
You may have serious skin reactions when you take hydroxyzine oral tablets. In studies of the drug, no skin reactions were reported. But these side effects have been reported since the first studies of the drug. nine0003
Skin reactions that hydroxyzine can cause include:
- acute generalized exanthematous pustulosis (AGEP), which is a rare condition that causes skin problems and high white blood cell counts.
- erythema multiforme
- excessive sweating
- Stevens-Johnson syndrome
- toxic epidermal necrolysis 003
- Pustules (luna filled with fluid)
- Rapid edema
- Red or Preshi, fiolnaya or pushy. Skin irritation
- skin rash
- redness (temporary warmth, redness or discoloration of the skin)
- to treat anxiety
- to treat itching
- to help induce sedation (a state of sleepiness and relaxation) before or after you receive anesthesia for surgery
- chest pain
- increased heart rate
- shortness of breath
- difficulty breathing
- 10 milligrams (mg)
- 25 mg
- 50 mg
- For anxiety, you will take hydroxyzine oral tablets up to four times a day.
- For itching, you will take hydroxyzine oral tablets three or four times a day.
- For sedation (a state of sleepiness and relaxation), your doctor will tell you how often you need to take hydroxyzine oral tablets.
- What if I miss a dose of Hydroxyzine Oral Tablets? Take the missed dose as soon as you remember. But if it's almost time for the next dose, skip the missed dose. Then take the next dose at the usual time. If you are not sure whether to skip a dose or take it, talk to your doctor or pharmacist. nine0024
- Do I need to use hydroxyzine oral tablets for a long time? No, you probably won't use hydroxyzine oral tablets for a long time. This drug has not been studied for more than 4 months of use to treat anxiety. Your doctor will tell you how long you should take hydroxyzine oral tablets.
- Can hydroxyzine oral tablets be chewed, crushed or divided? The manufacturer of Hydroxyzine did not indicate whether these tablets can be chewed, crushed, or divided. If you have trouble swallowing hydroxyzine tablets whole, talk to your doctor or pharmacist. nine0024
- Should I take hydroxyzine oral tablets with food? You can take hydroxyzine oral tablets with or without food.
- How long do hydroxyzine oral tablets last? You should notice that hydroxyzine will relieve your symptoms within 1 hour of taking the tablets. Some people may feel effects as early as 15 to 30 minutes after taking a dose.
- Before the meeting, write down questions such as:
- How will hydroxyzine oral tablets affect my body, mood, or lifestyle?
- Take someone with you to the meeting if it makes you feel more comfortable.
- If you do not understand something about your condition or treatment, ask your doctor to explain it to you.
- Treat anxiety. Anxiety is an unpleasant feeling of intense fear or anxiety about everyday situations. For this use, the drug is given for short-term relief of anxiety symptoms.
- Treat itching. Itching may be caused by allergies or other skin conditions such as hives, eczema and dermatitis.
- Help induce sedation. Sedation is a state of sleepiness and relaxation. For this use, the drug is given before or after you receive anesthesia for surgery. nine0024
- all medical conditions you have
- your general health
- medicines for blood pressure
- Preparations that reduce the activity of the central nervous system, such as:
- Preparations split in the organism of enzymes (types of proteins) called CYP2D6, called CYP2D6 and CYP3A5, for example:
Hydroxyzine Oral Tablets may not be right for you if you have certain medical conditions or other factors affecting your health. Talk to your doctor about your medical history before taking hydroxyzine oral tablets. Factors to consider include those listed in the list below.
- Heart problems. Tell your doctor about any heart problems you have before taking hydroxyzine oral tablets. Hydroxyzine can cause abnormal heart rhythms and low blood pressure. Your risk of these side effects is higher if you already had heart problems before taking hydroxyzine. nine0024
- Liver or kidney problems. If you have liver or kidney problems, tell your doctor before taking hydroxyzine oral tablets. Your doctor may need to adjust the dosage of the drug. They may also monitor side effects from hydroxyzine more closely.
- Allergic reaction. If you have had an allergic reaction to hydroxyzine oral tablets or any of their ingredients, you should not take this medicine. Also tell your doctor if you have had an allergic reaction to cetirizine (Zyrtec) and levocetirizine (Xyzal). These drugs are similar to hydroxyzine. Ask your doctor about other medicines that may be the best option for you. nine0024
- Conditions affecting breathing, digestion, muscle movements, urination and vision. Hydroxyzine may worsen these conditions. If you have one of these conditions, your doctor may recommend a treatment other than hydroxyzine. Before taking hydroxyzine oral tablets, tell your doctor if you have:0024
- Problems with urination
- Use of monoamyoxids inhibitors (IMAO). You should not take hydroxyzine oral tablets with an MAOI. MAOIs are a group of drugs used to treat depression. Taking hydroxyzine with an MAOI may increase the risk of some of the side effects of hydroxyzine. These include low blood pressure, breathing problems, and decreased central nervous system activity. Before you start taking hydroxyzine oral tablets, tell your doctor if you are taking an MAOI. You will most likely be prescribed another drug besides hydroxyzine. nine0024
- Taking medications that can cause heart rhythm disturbances. You should not take hydroxyzine oral tablets with certain medicines that can cause abnormal heart rhythms. Since hydroxyzine can also cause this side effect, taking the drugs together increases the risk of heart rhythm problems. Examples of such drugs include:
Tell your doctor right away if you have symptoms of skin reactions from hydroxyzine oral tablets.
In some cases, skin reactions from hydroxyzine oral tablet can be life-threatening. Call 911 or your local emergency number if you have a fever, blisters, swelling of the skin, or painful areas of the skin. These may be signs of a medical emergency that needs to be treated immediately.
Some people may have an allergic reaction to hydroxyzine oral tablets. Allergic reactions to hydroxyzine have been reported after initial studies of the drug were conducted.
Symptoms of a mild allergic reaction may include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction may include swelling under the skin, usually on the eyelids, lips, hands, or feet. They may also include swelling of the tongue, mouth, or throat, which can cause breathing problems.
Call your doctor right away if you have an allergic reaction to hydroxyzine oral tablets. But if you think you need a medical emergency, call 911 or your local emergency number.
What are some frequently asked questions about hydroxyzine oral tablet?
Find answers to some frequently asked questions about hydroxyzine oral tablets.
Is hydroxyzine used to improve sleep? If yes, what is the dosage?
Hydroxyzine is not approved to improve sleep. But it may not be used for its intended purpose for this purpose. (Off-label use means that a medicine is given to treat a condition for which it is not approved.)
Hydroxyzine can affect everyone differently. Possible side effects of the drug are both drowsiness and insomnia. (If you have insomnia, you have trouble falling or staying asleep.)
So it's possible that hydroxyzine can help you sleep. But the drug may also keep you awake.
You will learn more about how hydroxyzine affects you after you have taken the drug for a few days.
To learn more about using hydroxyzine to improve sleep, talk to your doctor. nine0003
How long does the effect of hydroxyzine last? And how long does it stay on your system?
Hydroxyzine is a type of drug called an antihistamine.
It works by attaching to histamine receptors (binding sites) in your body. This produces a soothing effect that helps relieve anxiety and itching.
You may continue to experience these effects from hydroxyzine for several hours after taking the drug.
The half-life of hydroxyzine can be used to find out how long the drug stays in the body. The half-life of a drug is the time it takes for half the dose of the drug to leave the body. The half-life of hydroxyzine is about 14 hours. So it takes about 14 hours for your body to get rid of half the dose of hydroxyzine. nine0003
It usually takes about five half-lives for a drug to completely leave the body. For hydroxyzine, this means the drug will stay in your body for about 70 hours after your last dose.
To learn more about how hydroxyzine works and how long it lasts, talk to your doctor or pharmacist.
What should I know about hydroxyzine compared to Benadryl, Xanax, Lexapro or Zoloft?
Hydroxyzine belongs to a group of medicines called antihistamines. It is prescribed:
Diphenhydramine (Benadryl) is also an antihistamine. It is available without a prescription, so you don't need a prescription. Benadryl is also used to treat itching and other allergy symptoms. nine0003
Alprazolam (Xanax), escitalopram (Lexapro), and sertraline (Zoloft) are prescription drugs that can be used for anxiety. Xanax is a benzodiazepine, while Lexapro and Zoloft are antidepressants.
To find out more about how hydroxyzine compares to these medicines, talk to your doctor or pharmacist.
Is hydroxyzine a benzodiazepine or other controlled substance? Will it make me feel "high"?
Hydroxyzine is not a benzodiazepine or a controlled substance. (Controlled substances have a higher risk of abuse than other drugs.)
Instead, hydroxyzine belongs to a group of medicines called antihistamines.
You may feel calm and relaxed after taking hydroxyzine. But euphoria (feeling "high" or full of energy) was not the side effect reported in the studies of the drug. In addition, hydroxyzine is known to be non-addictive. (In dependence, the drug is taken even if it causes harmful effects.)
If you are concerned about how hydroxyzine might affect you, talk to your doctor. nine0003
Does hydroxyzine cause weight gain?
Hydroxyzine does not appear to cause weight gain. This side effect was not reported in studies of the drug.
If you are concerned about weight gain while taking hydroxyzine, talk to your doctor. They can suggest healthy ways to manage your body weight.
Do certain side effects of hydroxyzine affect older people more than younger people?
Yes, the side effects of hydroxyzine may affect older people more than younger people. nine0003
Older adults may have certain health conditions that affect their body's response to hydroxyzine. These conditions include kidney and liver problems. And conditions can increase the risk of side effects from hydroxyzine, such as drowsiness and confusion.
Because of this, hydroxyzine is not recommended for the elderly. If the drug is prescribed to the elderly, it is recommended to start with a low dosage.
If you are older, talk to your doctor about the risks and benefits of using hydroxyzine. nine0003
Does hydroxyzine have a specific dosage for panic attacks?
Hydroxyzine is not currently approved for the treatment of panic attacks. But hydroxyzine can be used off-label for this purpose. (Off-label use means that a medicine is given to treat a condition for which it is not approved. )
Panic attacks are sudden attacks of fear that occur for no apparent reason. They can cause symptoms such as:
How do I take hydroxyzine oral tablets?
Your doctor will tell you how you should take hydroxyzine oral tablets. They will also explain how much to take and how often. Be sure to follow your doctor's instructions. The following are commonly used dosages, but Always take the dosage prescribed by your doctor.
Taking hydroxyzine oral tablet
You will be taking hydroxyzine oral tablet by mouth.
They are available in the following strengths:
How often you take your hydroxyzine oral tablets depends on the reason you take them. For example:
Your doctor may prescribe a lower dose than usual if you are older or have kidney or liver problems. nine0003
The maximum dose of hydroxyzine oral tablets is 100 mg per day.
Questions about taking Hydroxyzine Oral Tablet
Here are answers to some common questions about taking Hydroxyzine Oral Tablet.
Questions to ask your doctor
You may have questions about hydroxyzine oral tablets and your treatment plan. It is important to discuss all your concerns with your doctor. nine0003
Here are some tips to help guide your discussion:
Remember that your doctor and other healthcare professionals are always available to help you. And they want you to get the best possible care. So don't be afraid to ask questions or offer feedback about your treatment.
What is hydroxyzine oral tablet used for?
If you have anxiety, allergies, or scheduled surgery, your doctor may prescribe hydroxyzine for you.
This is a prescription drug used for:
Hydroxyzine oral tablets are used for this purpose in adults and children 1 year of age and older.
Hydroxyzine belongs to a group of medicines called antihistamines. It works by attaching itself to histamine receptors (binding sites) in your body. This produces a soothing effect that helps relieve anxiety and itching.
What should I consider before taking hydroxyzine oral tablet?
It is important to consult a physician when considering treatment with hydroxyzine oral tablets. Here are some important topics to discuss with them:
These and other considerations are described in more detail below.
Taking medicines, vaccines, foods, and other things with a certain medicine can affect how it works. These effects are called interactions.
Be sure to tell your doctor about all medicines you are taking, including prescription and over-the-counter medicines, before taking hydroxyzine oral tablets. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with hydroxyzine oral tablets. nine0003
Interactions with drugs or supplements
Hydroxyzine oral tablets may interact with several types of drugs. This includes:
Use with alcohol
You should not drink alcohol while you are taking hydroxyzine oral tablets.
Drinking alcohol while taking hydroxyzine may worsen some of the drug's side effects. These side effects include:
- fatigue (lack of energy)
- concentration problems
Pregnancy and breastfeeding
You should not take hydroxyzine oral tablets if you are pregnant or breastfeeding.
The side effects of hydroxyzine have not been studied in people who took the drug during pregnancy. But the drug is known to cause harm to newborns exposed to the drug during pregnancy.
The following are possible symptoms that newborns may experience after birth:
- decreased activity of the central nervous system
- lack of oxygen in the brain
- movement disorders such as repetitive muscle tension and relaxation
- muscle weakness
- urinary retention (a condition that occurs when the bladder does not empty completely)
Except In addition, hydroxyzine can pass into breast milk. Thus, the side effects of hydroxyzine may affect a baby who is breastfeeding by someone who is taking the drug. (For possible side effects of hydroxyzine, see the "What are the side effects of hydroxyzine oral tablets?" section above.)
If you are pregnant, breastfeeding, or planning to become pregnant or breastfeeding, talk to your doctor. You will probably be prescribed another drug besides hydroxyzine.
How much does hydroxyzine oral tablet cost?
The cost of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. For current hydroxyzine oral tablet prices in your area, visit GoodRx.com. nine0003
Financial assistance may be available to pay for hydroxyzine oral tablets. Medicine Assistance Tool and NeedyMeds are two websites that provide resources to help reduce the cost of hydroxyzine oral tablets.
These websites also offer tools to help you find affordable health care and certain educational resources. To find out more, visit their websites.
What to do in case of an overdose?
Do not take more hydroxyzine oral tablets than your doctor has told you to. Using more can lead to serious side effects.
Symptoms of an overdose of
Symptoms caused by an overdose of hydroxyzine oral tablets may include:
- Anomal heart rhythms, such as the elongated QT interval and Torsades de Pointes
- Low Dreamies
- Low Dreamies
What to do if you have taken too much hydroxyzine oral tablet
Call your doctor if you think you have taken too much hydroxyzine oral tablet. You can also call 800-222-1222 to contact the American Association of Poison Control Centers or use their online resource. However, if you have severe symptoms, call 911 (or your local emergency number) immediately or go to the nearest emergency room. nine0020
What to ask your doctor
If you have questions about using hydroxyzine for anxiety, itching, or sedation, talk to your doctor. (Sedation is a state of sleepiness and relaxation.)
You can ask your doctor about other treatments for these conditions. Below are a few articles that you might find helpful:0024
In addition, here are some questions you can ask your doctor about hydroxyzine oral tablets:
- How long should I take hydroxyzine oral tablets?
- Should I use other treatments for anxiety, itching or sedation while I am taking hydroxyzine?
- Can I take hydroxyzine oral tablets with acetaminophen (Tylenol) or ibuprofen (Advil)?
- Will I have withdrawal symptoms if I stop taking hydroxyzine oral tablets? nine0024
Ask a pharmacist
Is hydroxyzine similar to other OTC antihistamines?
Hydroxyzine has some similarities to over-the-counter antihistamines. But basically these drugs are different.
Hydroxyzine and OTC antihistamines are similar in that both can be used to treat itching.
In addition, hydroxyzine and some over-the-counter antihistamines have a similar chemical structure. That's why you shouldn't use hydroxyzine if you've had an allergic reaction to the over-the-counter antihistamines cetirizine (Zyrtec) or levocetirizine (Xyzal). (In fact, when your body breaks down hydroxyzine, almost half the dose of hydroxyzine is converted to cetirizine.)
But hydroxyzine and OTC antihistamines also have some big differences. For example, hydroxyzine is not available without a prescription, which means you must have a prescription for it.
In addition, hydroxyzine is not used to treat seasonal allergies, unlike over-the-counter antihistamines. And over-the-counter antihistamines should not be used to treat anxiety, unlike hydroxyzine.
In addition, unlike hydroxyzine, over-the-counter antihistamines are not used for sedation. (Sedation is a state of sleepiness and relaxation.)
Hydroxyzine has more drug interactions than OTC antihistamines. And it can cause some serious side effects that are not seen with over-the-counter antihistamines. These side effects include abnormal heart rhythms.
If you want to know more about the similarities and differences between these drugs, talk to your doctor or pharmacist.
Alex Brewer, PharmD, MBA Answers represent the opinions of our medical experts. All content is for informational purposes only and should not be considered medical advice. nine0941
Registration data: Drink-Drink has made every effort to ensure that all information is accurate, complete and up to date. However, this article should not be used as a substitute for the knowledge and experience of a licensed healthcare professional. You should always check with your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or side effects.