Hydroxyzine is a prescription medication known for its antihistamine properties, often used to alleviate allergy symptoms like itching. It also acts as an anxiolytic, calming the central nervous system, and is prescribed for anxiety, insomnia, or as a sedative before medical procedures. Like all medications, hydroxyzine carries risks if not used as directed, including overdose. Understanding these risks and recognizing overdose signs are important for safe use.
Factors Influencing Hydroxyzine Overdose
Determining an exact overdose amount for hydroxyzine is not straightforward, as toxicity depends on several individual factors. Exceeding prescribed limits significantly increases risk. For adults, typical therapeutic dosages for anxiety range from 50 to 100 milligrams (mg) up to four times daily, with a maximum daily dose often around 400 mg. Doses for children are lower, determined by age and body weight.
Individual sensitivity plays a considerable role in how the body processes hydroxyzine. Very young children and older adults are more susceptible due to differences in metabolism and organ function. Pre-existing medical conditions, such as liver or kidney impairment, can hinder the body’s ability to clear the drug, leading to higher concentrations. Heart conditions, particularly those affecting the heart’s electrical activity like QT prolongation, also increase the risk of serious complications.
The danger of overdose is significantly heightened when hydroxyzine is combined with other central nervous system (CNS) depressants. Alcohol, opioids, benzodiazepines, other sedatives, and even other antihistamines can amplify hydroxyzine’s effects, increasing the risk of severe sedation and respiratory depression. Medications affecting heart rhythm can also interact dangerously, potentially leading to cardiac arrhythmias.
Recognizing Overdose Symptoms
Identifying the signs of a hydroxyzine overdose is important for prompt intervention. Common symptoms often reflect the medication’s sedative and anticholinergic properties. These include pronounced drowsiness, excessive sedation, confusion, disorientation, and blurred vision. Other symptoms include dry mouth, nausea, vomiting, dizziness, or a rapid heartbeat.
More severe and dangerous symptoms indicate significant toxicity, requiring immediate medical attention. These include seizures, severe low blood pressure (hypotension), or respiratory depression, characterized by slow and shallow breathing. Other serious signs are cardiac arrhythmias, hallucinations, severe agitation, tremors, uncoordinated movement, stupor, or coma.
Emergency Response and Medical Care
If hydroxyzine overdose is suspected, immediate action is necessary. It is important to call emergency services (e.g., 911) or a poison control center immediately. When speaking with emergency personnel, provide as much information as possible, including what was taken, the approximate amount, when it was ingested, the patient’s age and weight, and any other substances involved.
While awaiting professional medical help, avoid attempting to induce vomiting unless instructed by a medical professional or poison control. Do not give anything by mouth if the person is unconscious or experiencing seizures. Medical treatment for hydroxyzine overdose primarily focuses on supportive care, as there is no specific antidote for the medication.
In a medical setting, care involves closely monitoring vital signs, such as heart rate, blood pressure, and breathing, and ensuring a clear airway. Intravenous fluids may support circulation, and activated charcoal might reduce drug absorption if the overdose was recent. Medical professionals will manage symptoms as they arise, which could include administering medications for seizures or to stabilize blood pressure. ECG monitoring is recommended to check for heart rhythm abnormalities.
Preventing Accidental Overdose
Preventing an accidental hydroxyzine overdose involves careful adherence to prescribed guidelines and responsible medication practices. Always follow the dosage and frequency instructions provided by a healthcare provider. Taking more than prescribed or more often than directed significantly increases adverse effects.
Avoid self-medicating with hydroxyzine or sharing it with others, as dosages are individualized based on a person’s specific medical needs. Inform all healthcare providers (doctors, pharmacists) about all medications, supplements, and herbal remedies. This complete list helps them identify potential drug interactions that could increase overdose risk, especially with other CNS depressants like alcohol.
Proper storage of hydroxyzine is also a key preventative measure. Keep the medication in its original container, securely out of reach of children and pets. Dispose of any unused or expired medication properly, often by following local guidelines or consulting a pharmacist, to prevent accidental ingestion.