Hydroxyzine Pamoate Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing

Uses

Hydroxyzine is used to treat itching caused by allergies. It is an antihistamine and works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. Hydroxyzine may also be used short-term to treat anxiety or to help you feel sleepy/relaxed before and after surgery.

How to use Hydroxyzine Pamoate

Take this medication by mouth with or without food as directed by your doctor, usually three or four times daily.

The dosage is based on your age, medical condition, and response to treatment. In children, the dosage may also be based on weight. Do not increase your dose or take this medication more often than directed.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Drowsiness, dizziness, blurred vision, constipation, or dry mouth may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To relieve dry mouth, suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as restlessness, confusion, hallucinations), shaking (tremor), difficulty urinating.

Get medical help right away if you have any very serious side effects, including: seizures, fast/irregular heartbeat, severe dizziness, fainting.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking hydroxyzine, tell your doctor or pharmacist if you are allergic to it; or to cetirizine; or to levocetirizine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as emphysema, asthma), high pressure in the eye (glaucoma), high blood pressure, kidney problems, liver problems, seizures, stomach/intestine problems (such as ulcer, blockage), overactive thyroid (hyperthyroidism), difficulty urinating (for example, due to enlarged prostate).

Hydroxyzine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before taking hydroxyzine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about taking hydroxyzine safely.

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Children may be more sensitive to the side effects of this drug. This drug can often cause excitement in young children instead of drowsiness.

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, confusion, constipation, trouble urinating or QT prolongation (see above). Drowsiness and confusion can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Interactions

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor’s approval.

Tell your doctor or pharmacist if you are taking other products that cause drowsiness such as opioid pain or cough relievers (such as codeine, hydrocodone), alcohol, marijuana (cannabis), drugs for sleep or anxiety (such as alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or other antihistamines (such as diphenhydramine, promethazine).

Check the labels on all your medicines (such as allergy or cough-and-cold products) because they may contain ingredients that cause drowsiness. Ask your pharmacist about using those products safely.

Do not use with any other antihistamines applied to the skin (such as diphenhydramine cream, ointment, spray) because increased side effects may occur.

Hydroxyzine is very similar to cetirizine and levocetirizine. Do not use these medications while using hydroxyzine.

This medication may interfere with certain laboratory tests (including allergy skin testing, urine corticosteroids level), possibly causing false test results. Make sure laboratory personnel and all your doctors know you use this drug.

Does Hydroxyzine Pamoate interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: severe drowsiness, seizures. In children, mental/mood changes (such as restlessness, irritability) may occur before drowsiness.

Do not share this medication with others.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

Images

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CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

Mental Health Medications | NAMI: National Alliance on Mental Illness

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Generic name: hydroxyzine (hye DROKS i zeen)

• Capsules: 25 mg, 50 mg, 100 mg

Brand name: Vistaril®

• Capsules: 25 mg, 50 mg

​All FDA black box warnings are at the end of this fact sheet. Please review before taking this medication.

What Is Hydroxyzine And What Does It Treat?

Hydroxyzine is an antihistamine. It is approved for the treatment of anxiety. However, hydroxyzine is also used to treat difficulty sleeping, nausea, vomiting, itching, skin rash, and allergies.

Symptoms of anxiety include:

• Feeling nervous
• Feeling fearful
• Excessive worrying
• Difficulty sleeping
• Difficulty concentrating
• Irritability

What Is The Most Important Information I Should Know About Hydroxyzine?

Do not drive a car or operate machinery until you know how this medication affects you because you may notice that you feel tired or dizzy.

Hydroxyzine is not a controlled substance. It does not have the risk of addiction like some other medications used to treat anxiety e.g., lorazepam (Ativan®), alprazolam (Xanax®), clonazepam (Klonopin®), and other benzodiazepines.

Are There Specific Concerns About Hydroxyzine And Pregnancy?

If you are pregnant or planning to become pregnant, notify your health care provider to best manage your medications. People living with anxiety disorders who wish to become pregnant face important decisions. It is important to discuss this with your doctor and caregivers.

Hydroxyzine should not be used in the first trimester of pregnancy. Studies that were done with mice, rabbits, and rats found an increased risk of birth defects. The risk to humans in the first trimester is unclear due to lack of well-controlled studies in humans. Hydroxyzine may be used in the second and third trimesters of pregnancy, but it should not be used during or just prior to labor. Use of hydroxyzine during labor may increase seizure risk in infants, decrease fetal heart rate, and increase side effects when combined with narcotics.

Regarding breastfeeding, use is not recommended since hydroxyzine does pass into breast milk. Infants who have received other antihistamines have experienced drowsiness, irritability, or unusual excitement. In addition, it may lower milk production in the mother.

What Should I Discuss With My Health Care Provider Before Taking Hydroxyzine?

• Symptoms of your condition that bother you the most
• If you have thoughts of suicide or harming yourself
• Medications you have taken in the past for your condition, whether they were effective or caused any adverse effects
• If you experience side effects from your medications, discuss them with your health care provider. Some side effects may pass with time, but others may require changes in the medication.
• Any other psychiatric or medical problems you have, including obstructive sleep apnea or abnormal heartbeat
• All other medications you are currently taking (including over the counter products and herbal and nutritional supplements) and any medication allergies you have, including allergies to cetirizine (Zyrtec®) or levocetirizine (Xyzal®)
• Other non-medication treatment you are receiving, such as talk therapy or substance abuse treatment. Your provider can explain how these different treatments work with the medication.
• If you are elderly or are prone to falls
• If you are pregnant, plan to become pregnant, or are breastfeeding
• If you drink alcohol or use drugs
• If you have a heart condition known as a prolonged QT interval

How Should I Take Hydroxyzine?

Hydroxyzine may be taken with or without food. Take with food if you experience an upset stomach.

Hydroxyzine may be taken every day at regular times or on an as needed (“PRN”) basis. Typically, your health care provider will limit the number of doses you should take in one day.

Your health care provider will determine the dose and method of taking the medication that is right for you based upon your response.

If you take the medication every day (instead of ‘as needed’), use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take it. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.

What Happens If I Miss A Dose Of Hydroxyzine?

If you miss a dose of hydroxyzine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your next dose or take more than what is prescribed.

What Should I Avoid While Taking Hydroxyzine?

Avoid drinking alcohol and using illegal drugs while you are taking hydroxyzine. They may decrease the benefits (e.g., worsen your condition) and increase the adverse effects (e.g., sedation) of the medication.

What Happens If I Overdose With Hydroxyzine?

If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.

Symptoms of overdose include severe drowsiness, dry mouth, difficulty urinating, headache, rapid heartbeat, confusion, impaired coordination, slow reflexes, seizures, or coma.

A specific treatment to reverse the effects of hydroxyzine does not exist.

What Are Possible Side Effects Of Hydroxyzine?

Common side effects

• Dizziness, drowsiness, fatigue, dry mouth
• Urinary retention, blurred vision, confusion, irritability
• Headache

Rare/serious side effects

• Allergic reaction (difficulty breathing; hives; swelling of your lips, tongue or face)
• Increased heart rate, unsafe heart beat (long QT on ECG), confusion, hallucinations
• Priapism (an erection in males that does not go away after 4 hours)
• Skin rash known as acute generalized exanthematous pustulosis (AGEP)

Are There Any Risks For Taking Hydroxyzine For Long Periods Of Time?

To date, there are no known problems associated with the long-term use of hydroxyzine. It is a safe and effective medication when used as directed.

A physician should reassess periodically the usefulness of the drug for the individual patient.

What Other Medications May Interact With Hydroxyzine?

The following medications may increase the levels and effects of hydroxyzine:

• Other antihistamines, such as diphenhydramine (Benadryl®) and cetirizine (Zyrtec®)
• Other medications with anticholinergic effects, such as benztropine (Cogentin®)
• Other medications that can cause drowsiness, such as zolpidem (Ambien®)
• Other medications that increase the heart’s QT interval such as amitriptyline (Elavil®), citalopram (Celexa®), and methadone.

How Long Does It Take For Hydroxyzine To Work?

Symptoms of anxiety or insomnia may improve within hours of the first dose of medication.

Summary of FDA Black Box Warnings

Hydroxizine does not have any black box warnings. 

Provided by

(January 2023)

©2022 The American Association of Psychiatric Pharmacists (AAPP) and the National Alliance on Mental Illness (NAMI). AAPP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.

This information is being provided as a community outreach effort of the American Association of Psychiatric Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The American Association of Psychiatric Pharmacists disclaims any and all liability alleged as a result of the information provided herein.

ICSC 0709 – HYDROXYLAMINE HYDROCHLORIDE

ICSC 0709 – HYDROXYLAMINE HYDROCHLORIDE

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Chinese – ZHEnglish – ENFinnish – FIFrench – FRGerman – DEHebrew – HEHungarian – HUItalian – ITJapanese – JAKorean – KOPersian – FAPolish – PLPortuguese – PTRussian – RUSpanish – ES

	SPECIAL HAZARDS	PREVENTIVE MEASURES	FIRE EXTINGUISHING
FIRE AND EXPLOSION	Not combustible. In a fire, releases irritating or toxic fumes (or gases). Risk of explosion due to decomposition when heated.		In case of fire in work area, use appropriate extinguishing media.

AVOID ALL CONTACT! IN ALL CASES, CONSULT A DOCTOR!
	SYMPTOMS	PREVENTIVE MEASURES	FIRST AID
Inhalation	Blue lips, nails and skin. Headache. Dizziness. Nausea. Clouding of consciousness. Seizures. Loss of consciousness.	Apply ventilation (if not powder). Use local exhaust or respiratory protection.	Fresh air, peace. Seek medical attention.
Leather	CAN BE ABSORBED! Redness. Pain. Further See Inhalation.	Protective gloves.	Remove contaminated clothing. Rinse skin with plenty of water or take a shower. seek medical attention.
Eyes	Redness. Pain.	Use goggles or eye protection in combination with respiratory protection if the substance is in powder form.	First of all, rinse with plenty of water for several minutes (remove contact lenses if possible without difficulty), then seek medical advice.
Ingestion	See inhalation.	Do not eat, drink or smoke while working.	Rinse your mouth. Give a suspension of activated charcoal in water to drink. Seek medical attention.

LEAK DISPOSAL	CLASSIFICATION AND LABELING
Personal protection: Particulate filter respirator suitable for the concentration of the substance in the air. Do NOT allow this chemical to enter the environment. Non-metallic Sweep spilled substance into covered containers. If necessary, wet first to avoid dust. Carefully collect the rest. Then store and dispose of in accordance with local regulations.	According to UN GHS criteria DANGER May be corrosive to metals Toxic if swallowed Harmful in contact with skin Causes skin and eye irritation May cause an allergic skin reaction Suspected of causing cancer May cause blood damage May cause blood damage through prolonged or repeated exposure Very toxic to aquatic life Transport UN classification UN hazard class: 8; Additional UN risks: 6.1; UN Packing Group: III
STORAGE
Keep dry. Cool place. Store in areas without drains or access to sewerage. Prevent fire extinguishing products from entering sewage.
PACKAGING
Do not transport with food or animal feed. Pollutes the marine environment.

NOTES
DO NOT take work clothes home. Decomposition of compound starts at 154°C. Depending on the degree of exposure, periodic medical examination is recommended. In case of poisoning with this substance, specific treatment is necessary; appropriate means with instructions must be available. See ICSC cards 0661 and 1747.

ICSC 0661 – HYDROXYLAMINE

ICSC 0661 – HYDROXYLAMINE

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Chinese – ZHEnglish – ENFinnish – FIFrench – FRGerman – DEHebrew – HEHungarian – HUItalian – ITJapanese – JAKorean – KOPersian – FAPolish – PLPortuguese – PTRussian – RUSpanish – ES

	SPECIAL HAZARDS	PREVENTIVE MEASURES	FIRE EXTINGUISHING
FIRE AND EXPLOSION	In a fire, emits irritating or toxic fumes (or gases). Risk of explosion if heated. Risk of explosion on contact with many substances. See Chemical Hazards.	DO NOT use open flames, DO NOT spark, DO NOT SMOK. DO NOT allow contact with hot surfaces.	Use plenty of water, alcohol-resistant foam, powder. In case of fire: cool drums, etc. spraying water. Fight fire from cover.

AVOID ALL CONTACT! IN ALL CASES, CONSULT A DOCTOR!
	SYMPTOMS	PREVENTIVE MEASURES	FIRST AID
Inhalation	Cough. Sore throat. Dizziness. Headache. Blue lips, nails and skin. Confused breath. Weakness.	Use ventilation, local exhaust or respiratory protection.	Fresh air, peace. Oxygen supply may be required. Seek immediate medical attention. See Notes.
Leather	CAN BE ABSORBED! Redness. Pain. Further See Inhalation.	Protective gloves. Protective clothing.	Remove contaminated clothing. Rinse skin with plenty of water or take a shower. Seek immediate medical attention.
Eyes	Redness. Pain. Severe burns.	Use face mask or eye protection in combination with respiratory protection.	Rinse with plenty of water for several minutes (remove contact lenses if possible without difficulty). Seek immediate medical attention.
Ingestion	Nausea. Vomit. Symptoms may be delayed. Read More See inhalation.	Do not eat, drink or smoke while working.	Rinse your mouth. Oxygen supply may be required. Seek medical attention. See Notes.

LEAK DISPOSAL	CLASSIFICATION AND LABELING
Personal protection: Particulate filter respirator suitable for the concentration of the substance in the air. Do NOT allow this chemical to enter the environment. Non-metallic Sweep spilled substance into covered containers. If necessary, wet first to avoid dust. Carefully collect the rest. Then store and dispose of in accordance with local regulations.	According to UN GHS criteria DANGER Unstable explosive May be corrosive to metals Harmful if swallowed or in contact with skin Causes skin irritation Causes serious eye damage May cause an allergic skin reaction Suspected of causing cancer May cause respiratory irritation May cause blood poisoning May cause blood damage through prolonged or repeated exposure Very toxic to aquatic life Transport UN classification
STORAGE
Ensure fire resistance. Separated from incompatible materials. See chemical hazards. Cool place. Keep dry. Good to close. Store in areas without drains or access to sewerage. Prevent fire extinguishing products from entering sewage.
PACKAGING
Do not transport with food or animal feed. Pollutes the marine environment.

ENVIRONMENT
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