Patient Education: Hydroxyzine

Hydroxyzine is a medication prescribed by your healthcare provider, selected based on current evidence-based guidelines to best address specific mental health conditions. While effective, it's important to understand that all medications come with potential side effects. As a patient or caregiver, being informed about these risks and benefits is crucial. Equally essential is knowing how to monitor for side effects, and understanding the strategies to reduce their occurrence or manage them effectively. This guide aims to empower you with this knowledge, ensuring a well-informed approach to your or your child's treatment.

What is Hydroxyzine?

Hydroxyzine is an antihistamine medication (same medication class as Benadryl) and works by blocking the histamine H1 receptors in the brain.

When is Hydroxyzine prescribed to Children & Adolescents? 

• Anxiety: Prescribed as an "as needed" medication for rapid relief of anxiety symptoms. It can also be used on a scheduled daily basis for short-term management of anxiety until your primary treatment becomes effective.
• Insomnia: Especially useful when insomnia is due to anxiety.
• Other Non-Psychiatric Uses: Treatment of allergies, motion sickness, and nausea and vomiting after surgery.

What is the Dose of Hydroxyzine?

• Anxiety: 10-50 mg, taken every 4 to 6 hours “as needed” for rapid relief of anxiety symptoms. 
• Insomnia: 10-50mg, taken at bedtime

Medication Guidelines: What You Need to Know

• For treatment of anxiety, it is particularly effective in alleviating physical symptoms secondary to anxiety like nausea, racing heartbeat, jitteriness. 
• It's important to note that while the medication is not habit-forming, regular use can lead to tolerance, which may require higher doses over time. Therefore, it is generally recommended for use only as needed in treating anxiety or as a short-term aid for sleep.
• For your safety, avoid driving or operating machinery immediately after taking this medication as it can cause drowsiness, especially when you just start taking it.

What can be the possible

side-effects from the medication?

Common Side-Effects & their Management Strategies: 

Your child may experience some side effects from the medication initially. Most of these side effects are mild and improve over time. The medication is started at a low dose to minimize these side effects. If side effects persist, consult your healthcare provider.

• Tiredness, Drowsiness, Dizziness: These side-effects may occur, especially with initial doses, and can linger into the next day causing daytime drowsiness. Typically, these symptoms are temporary and lessen with continued use or a reduced dose.

• Dry Mouth, Constipation: Regular hydration can alleviate this symptom. Try to drink water frequently throughout the day.

• Headache: May happen initially but usually improves over time. Consult with your provider if persistent. Reducing the dosage might help. 

Less Common Side-Effects:

• Confusion, Memory problems: These side effects are more common in older adults (over 65 years), at higher doses, when used in combination with other medications that have similar effects, or with concurrent alcohol use.

Serious but Rare Side-Effects

• QT interval prolongation: Higher doses can cause increase in the QT interval, a measure of time in the heart's electrical cycle. This prolongation can potentially lead to a life-threatening heart rhythm disorder known as torsade de pointes. While the increase in QT interval with Hydroxyzine is typically minor and not a concern on its own, it can be significant if you have other heart-related risks. Additionally, it should not be used with other drugs that prolong the QT interval. 
  
  
• Urinary Retention: This side-effect is rarely reported. If you suspect urinary retention, it is important to visit the emergency room promptly as catheterization may be necessary.
  
  
• Exacerbation of narrow-angle Glaucoma: Use this medication with caution if you have narrow-angle glaucoma, as it may exacerbate the condition. If you are taking hydroxyzine and experience symptoms such as eye pain, vision changes, swelling, or redness, seek immediate emergency medical care. Untreated narrow-angle glaucoma can lead to permanent blindness
  
  
  

To learn more about this medication please visit MedlinePlus, a official US government website, part of National Library of Medicine and managed by National Institute of Health by clicking HERE