What is hydroxyzine (Vistaril)?
Hydroxyzine is an antihistamine with anticholinergic (drying) and sedative properties that is used to treat allergic reactions.
What brand names are available for hydroxyzine?
- Vistaril is the brand name available for hydroxyzine in the US.
- Atarax and Hy-Pam25, Orgatrax brands have been discontinued and are no longer available in the US.
Is hydroxyzine (Vistaril) available as a generic drug?
Yes
Do I need a prescription for hydroxyzine (Vistaril)?
Yes
What are the uses for hydroxyzine (Vistaril)?
- Hydroxyzine is used for the relief of pruritus (itching) caused by various allergic conditions.
- Hydroxyzine also is used to treat anxiety and tension, and inducing sedation prior to or after anesthesia.
- Hydroxyzine also is used to treat nausea, vomiting, and alcohol withdrawal.
What are the side effects of hydroxyzine (Vistaril)?
Common side effects of hydroxyzine are:
- Sedation
- Sleepiness
- Disturbed coordination
- Drying and thickening of oral and other respiratory secretions
- Stomach distress
Other important side effects include:
Hydroxyzine should be used with caution (if at all) in persons with
narrow-angle glaucoma,
prostatic hypertrophy (enlarged
prostate gland),
hyperthyroidism,
cardiovascular disease,
hypertension, and
asthma.
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What is the dosage for hydroxyzine (Vistaril)?
- Hydroxyzine has its maximal effect about 30 to 60 minutes after it is taken. Its effects last for 4 to 6 hours.
- The recommended dose for treating itching (pruritus) is 25 mg given 3 or 4
times daily by mouth or by intramuscular injection. - When used for sedation, the
recommended dose is 50 to 100 mg orally or 25 to 100 mg by intramuscular
injection. -
Anxiety and tension are managed with 50 to 100 mg in 4 divided doses
or 50-100 mg intramuscular injection in 4 or 6 divided doses. -
Alcohol withdrawal
is treated with a 50-100 mg injection and may be repeated every 4 to 6 hours as
needed. - The dose for
nausea and
vomiting is 25 to 100 mg by injection. - Hydroxyzine can be taken with or without food.
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Which drugs or supplements interact with hydroxyzine (Vistaril)?
Hydroxyzine adds to (exaggerates) the sedating effects of
alcohol and other drugs
that can cause sedation such as the benzodiazepine class of anti-anxiety drugs.
These drugs include
- diazepam (Valium),
- lorazepam (Ativan),
- clonazepam (Klonopin), and
- alprazolam (Xanax).
Hydroxyzine also adds to the sedating effects the narcotic class of pain
medications and its derivatives, for example
- oxycodone and acetaminophen (Percocet),
- hydrocodone/acetaminophen (Vicodin),
- hydromorphone (Dilaudid),
- codeine,and
- propoxyphene (Darvon).
Hydroxyzine also adds to the effects of the tricyclic class of antidepressants,
for example
- amitriptyline (Elavil, Endep),
- imipramine (Tofranil), and
- desipramine (Norpramin)).
Hydroxyzine also adds to the effects of certain antihypertensive medications,
for example,
clonidine
(Catapres), and
propranolol
(Inderal).
Hydroxyzine can also intensify the drying effects of other medications with
anticholinergic properties, for example
- dicyclomine (Bentyl),
- bethanechol (Urecholine),
- Probanthine,
- amitriptyline (Elavil, Endep), and
- chlorpromazine (Thorazine).
When using these drugs, the dose of hydroxyzine may require reduction.
Is hydroxyzine (Vistaril) safe to use during pregnancy or while breastfeeding?
- A limited number of studies of hydroxyzine in
pregnant women suggests that there may be a relationship between its use in the
first trimester
of pregnancy and congenital abnormalities in the fetus. Therefore, hydroxyzine
should be avoided during the first trimester of pregnancy. - It is not known if hydroxyzine is excreted into breast milk.
In general, antihistamines are not recommended for use during
breastfeeding
because they can cause stimulation or
seizures in newborns.
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What else should I know about hydroxyzine (Vistaril)?
What preparations of hydroxyzine (Vistaril) are available?
- Tablets: 10, 25, 50 and 100 mg.
- Capsules: 25, 50 mg.
- Syrup: 10 mg per
teaspoonful (5mL). - Suspension: 25 mg per teaspoonful (5mL).
- Injection: 25 and 50
mg/ml
How should I keep hydroxyzine (Vistaril) stored?
- Capsules, tablets, and liquids should be stored at room temperature
15 C to 30 C (59 F to 86 F). - Liquid should not be frozen and should be shaken
well prior to each use. - Injectable hydroxyzine should be stored below 30 C (86
F).
How does hydroxyzine (Vistaril) work?
- The body releases histamine during several types of allergic
reactions and, to a lesser extent, during some viral infections, such as the
common cold.
When histamine binds to its receptors on cells, it causes the cells to release
chemical messengers that lead to
sneezing,
itching, and increased
mucus production. Antihistamines, like histamine, bind to the histamine
receptors. When they bind to the receptors, however, they do not stimulate the
cells to release chemical messengers. In addition, they prevent histamine from
binding and stimulating the cells. Hydroxyzine itself has no histamine-like
activity. After ingestion, it is converted to its active form. The active form
of hydroxyzine is a drug called
cetirizine
(Zyrtec). Although, both hydroxyzine and cetirizine act as antihistamines,
hydroxyzine causes more sedation than cetirizine.
When was hydroxyzine (Vistaril) approved by the FDA?
- The FDA approved hydroxyzine
in 1956.