Hydroxyzine

Hydroxyzine (Hydroxyzine) is a medicine that belongs to the class of antihistamines. It is used to treat various conditions such as allergic reactions, itching, and to reduce anxiety and tension.

Hydroxyzine works by blocking the action of histamine, the substance that causes allergy symptoms such as itching, rashes, runny nose and tearing. It also has properties that may reduce anxiety and provide a sedative (calming) effect.

This medication may be used to treat a variety of conditions, including allergic dermatitis, urticaria, dermatoses with severe itching, and to reduce anxiety and nervousness before surgery or in other situations.

Hydroxyzine is usually available in tablet, capsule, or syrup form for oral administration. It may also be available in injection form for use in hospitalized patients. As with any medication, the use of hydroxyzine should be under the guidance of a physician who will determine the optimal dosage and regimen depending on the specific clinical situation and individual patient characteristics.

Indications Hydroxyzine

Hydroxyzine is used to treat a variety of conditions including:

1. Allergic reactions: Hydroxyzine may be used to relieve symptoms of allergic reactions such as itching, rashes, runny nose, hives, and swelling.
2. Anxiolytic: This drug has anxiolytic effects and can be used to reduce anxiety, nervousness and tension.
3. Antiemetic Action: Hydroxyzine may be used to reduce nausea and vomiting, such as in seasickness or as a concomitant drug in the treatment of motion sickness.
4. Help in preparation for surgery: Hydroxyzine may be used to sedate and reduce anxiety in patients before surgery.
5. Drowsiness: In some cases, hydroxyzine may be used to treat insomnia because of its sedative effect.
6. Itching: The drug can also be used to relieve itching caused by various causes such as hives, allergies or skin diseases.

It is important to note that hydroxyzine may have sedative effects and cause drowsiness, so its use may be limited in situations where caution is required when driving vehicles or performing other activities requiring increased concentration.

Release form

It may be available in the following forms:

1. Tablets: Hydroxyzine is available as oral tablets. The tablets usually come in different dosages such as 10 mg, 25 mg or 50 mg.
2. Syrup: For the convenience of children or people who have difficulty swallowing solid forms of medication, hydroxyzine may be available as a syrup.
3. Injections: Hydroxyzine can also be presented as a solution for injection, which is commonly used in a hospital setting.
4. Capsules: Some manufacturers may produce hydroxyzine in the form of capsules for oral administration.

Pharmacodynamics

Its pharmacodynamics involves several major mechanisms of action:

1. Antihistamine action: Hydroxyzine is an antagonist of histamine H1 receptors. Histamine is a biologically active substance that plays a key role in the development of allergic reactions such as itching, swelling and redness of the skin. By blocking H1 receptors, hydroxyzine prevents or reduces these symptoms.
2. Anxiolytic (anti-anxiety) action: Hydroxyzine has anxiolytic properties, i.e. The ability to reduce anxiety in patients. This effect is probably due to its effects on certain neurotransmitter systems such as serotonin and gamma-aminobutyric acid (GABA).
3. Sedative effect: Hydroxyzine has a soporific effect that helps insomniac patients fall asleep. This is also due to its effect on neurotransmitter systems, particularly GABA.
4. Antiemetic Action: In some cases, hydroxyzine may be used to prevent nausea and vomiting due to its antihistamine properties.
5. Muscle relaxing effects: Some studies suggest that hydroxyzine may have a slight muscle relaxing effect, which may be beneficial for some conditions.

Pharmacokinetics

Here are the main aspects of the pharmacokinetics of hydroxyzine:

1. Absorption: Hydroxyzine is usually rapidly and completely absorbed from the gastrointestinal tract after ingestion. It may be administered in either tablet or liquid form.
2. Metabolism: Hydroxyzine undergoes extensive metabolism in the liver to form active metabolites, the main of which is cetirazine. Metabolism occurs via hydroxylation and oxidation.
3. Distribution: Hydroxyzine has a large volume of distribution, indicating its ability to penetrate the blood-brain barrier. It can also penetrate into breast milk.
4. Excretion: Hydroxyzine and its metabolites are excreted mainly through the kidneys. About 60-70% of the dose is excreted unchanged in the urine during the first 24 hours.
5. Temporal characteristics: The effect of hydroxyzine usually occurs within 30-60 minutes after ingestion. The duration of action may be 4 to 6 hours.
6. Factors affecting pharmacokinetics: The pharmacokinetics of hydroxyzine may be altered by various factors such as food, hepatic and renal status, presence of other drugs, etc.

Dosing and administration

1. To relieve anxiety and tension:

   • For adults: The usual starting dose is 25-50 mg of hydroxyzine taken 3-4 times a day. The maximum daily dose usually does not exceed 400 mg.
   • For children: The dosage depends on the age and weight of the child. It is generally recommended to start with a dose of 0.5 mg/kg divided into several doses throughout the day.

2. To relieve allergy symptoms:

   • For adults: 25 mg of hydroxyzine is usually taken 3-4 times a day. The maximum daily dose usually does not exceed 100 mg.
   • For children: The dosage depends on the age and weight of the child. It is generally recommended to start with a dose of 0.5 mg/kg divided into several doses throughout the day.

3. Countermechanism of circadian sleep:

   • For adults: The recommended dose is 25-50 mg of hydroxyzine taken approximately 30 minutes before bedtime.
   • For children: Dosage depends on the age and weight of the child. It is generally recommended to start with a dose of 0.5 mg/kg taken approximately 30 minutes before bedtime.

Use Hydroxyzine during pregnancy

The use of hydroxyzine during pregnancy requires special caution and should be carried out only under the guidance of a doctor. There are insufficient studies on its safety during pregnancy, therefore it is recommended to avoid its use, especially in the first trimester of pregnancy, when the organs and systems of the fetus are in the stage of active formation.

If a woman is taking hydroxyzine and discovers that she is pregnant, she should tell her doctor immediately. The doctor can assess the risk to the fetus and the benefit of the treatment, and if necessary, decide whether to continue taking hydroxyzine or switch to other treatments that are safer for pregnancy.

It is important to remember that any medicine, including hydroxyzine, should be used during pregnancy only for medical reasons and under the supervision of a doctor. Self-medication during pregnancy may pose a threat to the health of both mother and fetus.

Contraindications

1. Hypersensitivity: People with a known allergy to hydroxyzine or other components of its formula should not take this medication.
2. Patients with asthma or airway disease: Hydroxyzine may cause worsening of asthma symptoms or increased mucus secretion in the airways, which may lead to bronchial obstruction.
3. Bronchial asthma and chronic obstructive pulmonary disease (COPD): Use of hydroxyzine may cause worsening of symptoms of these diseases.
4. Pregnancy and breastfeeding: It is necessary to discuss the use of hydroxyzine with a doctor if a woman is pregnant or breastfeeding, as the safety of its use in these cases is not fully established.
5. Patients with acute attack of threatened ocular angle closure (angle chamber) glaucoma: Hydroxyzine may cause worsening of this condition.
6. Patients with porphyria: Hydroxyzine may increase the symptoms of this disease.
7. Patients with acute alcohol intoxication: Hydroxyzine may increase the sedative effect of alcohol.
8. Patients with renal disease: The dose of hydroxyzine may require adjustment in patients with impaired renal function.

Side effects Hydroxyzine

Here are some of the most common side effects of hydroxyzine:

1. Drowsiness and fatigue: This is one of the most common side effects of hydroxyzine. Many people report feeling drowsy, decreased concentration, and fatigue after taking the drug. This effect may be particularly pronounced when starting treatment or when the dose is increased.
2. Dizziness: Some people may experience dizziness or a feeling of unsteadiness after taking hydroxyzine.
3. Dry mouth: Hydroxyzine may cause dry mouth, which can be uncomfortable.
4. GI disorders: Some patients may experience gastrointestinal disorders such as nausea, vomiting, constipation or diarrhea.
5. Urinary tract irritation: In rare cases, hydroxyzine may cause urinary tract irritation or difficulty urinating.
6. Appetite and weight gain: Some people may experience an increase in appetite and consequent weight gain when taking hydroxyzine for long periods of time.
7. Rare side effects: These may include allergic reactions, mental status changes (e.g., agitation, insomnia, delusions), cardiac arrhythmias, and others.

Overdose

An overdose of this drug can present with a variety of symptoms, including:

1. Drowsiness and excessive fatigue.
2. Dizziness and loss of motor coordination.
3. Gastrointestinal disorders such as nausea, vomiting, or diarrhea.
4. Heart palpitations and changes in blood pressure.
5. Dry mouth and difficulty urinating.
6. Increased agitation or the occurrence of anxiety.

In case of suspected hydroxyzine overdose it is necessary to seek immediate medical attention. Treatment of overdose may include symptomatic therapy aimed at eliminating the manifestations of overdose, as well as monitoring of basic health parameters.

Hydroxyzine may interact with other medications, which may increase or decrease their effects and cause unwanted side effects. Some of the potential interactions include the following:

1. Sedatives and alcohol: Hydroxyzine increases the sedative effect of other drugs such as sleeping pills, antidepressants and alcohol. This may lead to a strong weakening of the activity of the central nervous system and cause drowsiness, respiratory depression and other undesirable effects.

2. Central anticholinergic drugs: Combining hydroxyzine with other anticholinergic drugs such as antidepressants, antiparkinsonian drugs, or antihistamines may increase the risk of side effects such as constipation, dry mouth, and difficulty urinating.

3. Centrally acting drugs for pain relief: Hydroxyzine may increase the sedative effect of centrally acting analgesics such as opiates, which may lead to an increased risk of decreased respiratory depression and drowsiness.

4. Antihypertensive drugs: Hydroxyzine may increase the effect of antihypertensive drugs, which may lead to a decrease in blood pressure.

5. MAO-inhibitors (monoamine oxidase inhibitors): Co-administration of hydroxyzine with MAO-inhibitors may result in serious side effects such as hypertensive crisis.

6. Drugs that depress the CNS (central nervous system): Combination of hydroxyzine with other drugs that also depress the CNS may increase the sedative effect.

7. Antiarrhythmic drugs: Hydroxyzine may increase the risk of arrhythmias when combined with antiarrhythmic drugs.

Interactions with other drugs

Hydroxyzine may interact with other medications, which may increase or decrease their effects and cause unwanted side effects. Some of the potential interactions include the following:

1. Sedatives and alcohol: Hydroxyzine increases the sedative effect of other drugs such as sleeping pills, antidepressants and alcohol. This may lead to a strong weakening of the activity of the central nervous system and cause drowsiness, respiratory depression and other undesirable effects.
2. Central anticholinergic drugs: Combining hydroxyzine with other anticholinergic drugs such as antidepressants, antiparkinsonian drugs, or antihistamines may increase the risk of side effects such as constipation, dry mouth, and difficulty urinating.
3. Centrally acting drugs for pain relief: Hydroxyzine may increase the sedative effect of centrally acting analgesics such as opiates, which may lead to an increased risk of decreased respiratory depression and drowsiness.
4. Antihypertensive drugs: Hydroxyzine may increase the effect of antihypertensive drugs, which may lead to a decrease in blood pressure.
5. MAO-inhibitors (monoamine oxidase inhibitors): Co-administration of hydroxyzine with MAO-inhibitors may result in serious side effects such as hypertensive crisis.
6. Drugs that depress the CNS (central nervous system): Combination of hydroxyzine with other drugs that also depress the CNS may increase the sedative effect.
7. Antiarrhythmic drugs: Hydroxyzine may increase the risk of arrhythmias when combined with antiarrhythmic drugs.

Storage conditions

Hydroxyzine should be stored in accordance with the manufacturer's instructions and the following general recommendations:

1. Temperature: Hydroxyzine is usually stored at room temperature, between 15 and 25 degrees Celsius. Avoid overheating the drug and store it in a cool place protected from direct sunlight.
2. Humidity: Hydroxyzine should be stored in a dry place to avoid exposure to moisture. Avoid storage close to the bathroom or other sources of high humidity.
3. Packaging: Follow the manufacturer's instructions regarding storage and packaging of hydroxyzine. It is usually supplied in light-protected containers or bottles.
4. Additional recommendations: It is important to follow any additional manufacturer's instructions, such as requirements for storage in original packaging or use of special storage conditions.
5. Children and animals: Keep hydroxyzine out of the reach of children and animals to prevent accidental use of the drug.
6. Expiration date: Check the expiration date of hydroxyzine and do not use after the expiration date.