Hydroxyzine is a medication used for anxiety, allergic reactions leading to itching, and for its sedative properties before medical procedures. As an antihistamine, it works by blocking histamine, a substance involved in allergic responses, and also affects brain activity to produce a calming effect. Understanding the appropriate dosage is important because it varies based on the condition being treated and individual patient characteristics. Proper use helps ensure the medication’s effectiveness while minimizing potential risks.
Hydroxyzine Dosage Guidelines
Hydroxyzine dosage is determined by the condition, patient’s age, and overall health. For adults, anxiety dosages range from 50 to 100 milligrams (mg) up to four times daily, with a daily maximum of 400 mg. For itching or allergic skin reactions, adults commonly take 25 mg three or four times per day, with a daily maximum of 100 mg. A single dose of 50 to 100 mg is administered for sedation before a medical procedure.
Children’s dosage differs, often based on body weight (e.g., 0.6 mg/kg for sedation). For anxiety or itching, children under six might receive 50 mg daily in divided doses, while those aged six and older may be prescribed 50 to 100 mg daily. Older adults generally require lower starting doses due to increased sensitivity and age-related changes in liver, kidney, or heart function. The maximum daily dose for elderly patients is typically 50 mg.
Individual health factors influence safe dosing. Healthcare providers exercise caution with patients with liver or kidney impairment, as these organs are crucial for drug metabolism and elimination. A healthcare professional’s guidance is necessary to determine the most appropriate and safe dosage for each individual.
Understanding Potential Risks
Hydroxyzine has various effects, even when prescribed. Common effects include drowsiness, dry mouth, and headaches. Some individuals may also experience nausea, weakness, or confusion.
More serious, though less common, effects include cardiac issues like QT prolongation, which can lead to irregular heart rhythms. This risk is higher with existing heart conditions, electrolyte imbalances, or other heart rhythm-affecting medications. Severe allergic reactions, including hives, difficulty breathing, or swelling, are also possible. Rarely, severe skin reactions or seizures have been reported.
Hydroxyzine can interact with other medications, increasing adverse effects. Combining it with central nervous system depressants (e.g., alcohol, opioids, benzodiazepines) may cause excessive sedation and respiratory depression. Heart rhythm medications (e.g., antiarrhythmics, antibiotics, antipsychotics) may increase QT prolongation risk. Hydroxyzine is generally not recommended during pregnancy or breastfeeding due to potential risks. Individuals with existing heart rhythm problems should also avoid this medication.
Recognizing Signs of Overdose
A mild to moderate hydroxyzine overdose may cause severe drowsiness or lethargy. Individuals might also exhibit confusion, slurred speech, unsteadiness, or a rapid heartbeat.
Severe hydroxyzine overdose symptoms can be life-threatening. Symptoms include seizures (uncontrolled electrical disturbances in the brain), hallucinations (seeing or hearing things not present), and respiratory depression (slow or shallow breathing), leading to coma. Other signs can involve low blood pressure, severe heart arrhythmias, tremors, or fever. Dry mouth, blurred vision, ringing in the ears, and difficulty with urination may also be present.
Emergency Response for Overdose
If a hydroxyzine overdose is suspected, immediate medical attention is crucial. Call emergency services (e.g., 911) or a Poison Control Center for guidance. They provide guidance and dispatch medical assistance. Avoid inducing vomiting unless specifically instructed by a healthcare professional, as this could worsen the situation.
When communicating with emergency responders or Poison Control, provide details. Such as the amount taken, ingestion time, and any other substances involved assists medical personnel. While waiting for professional help, monitor the individual’s breathing and heart rate. An overdose is a medical emergency requiring professional intervention for assessment and management.