Atarax: Effective Relief for Anxiety and Itching
Atarax
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| Product dosage: 25mg | |||
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Synonyms | |||
Atarax (hydroxyzine hydrochloride) is a first-generation antihistamine with anxiolytic, sedative, and antipruritic properties, widely prescribed in clinical practice for its dual therapeutic action. As a histamine H1-receptor antagonist, it modulates central nervous system activity, providing symptomatic relief for generalized anxiety disorder and pruritus associated with allergic conditions. Its well-established efficacy and favorable safety profile make it a versatile option in both psychiatric and dermatological contexts, offering rapid onset of action and predictable pharmacokinetics.
Features
- Active ingredient: Hydroxyzine hydrochloride
- Available in 10 mg, 25 mg, and 50 mg oral tablets
- Also supplied as hydroxyzine pamoate in capsule form
- Rapid absorption with peak plasma concentrations within 2 hours
- Metabolized hepatically via cytochrome P450 enzymes
- Excreted primarily renally
- Prescription-only medication
- Compatible with most standard pharmacy dispensing systems
Benefits
- Provides rapid relief from symptoms of anxiety and tension within 30-60 minutes of administration
- Effectively reduces pruritus associated with urticaria, dermatitis, and other allergic skin conditions
- Demonstrates sedative properties beneficial for pre-operative anxiety and insomnia management
- Exhibits antiemetic effects useful in controlling nausea and vomiting
- Offers cost-effective therapeutic alternative to newer anxiolytics
- Shows minimal abuse potential compared to benzodiazepines
Common use
Atarax is primarily indicated for the symptomatic management of anxiety disorders and tension states, where it demonstrates comparable efficacy to benzodiazepines without the same dependence risk. In dermatology, it is extensively used to control pruritus due to allergic conditions including chronic urticaria, atopic dermatitis, and contact dermatitis. Off-label applications include pre-operative sedation, adjunctive treatment in alcohol withdrawal, and management of nausea and vomiting. The medication is particularly valuable in patients requiring both anxiolytic and antipruritic effects, reducing polypharmacy concerns.
Dosage and direction
Dosage must be individualized based on patient response, indication, and clinical status. For anxiety management in adults: initial dose of 50-100 mg daily in divided doses, titrated upward to maximum 400 mg daily if necessary. For pruritus: 25 mg three to four times daily. Geriatric patients typically require lower initial doses (25-50 mg daily) due to reduced hepatic metabolism and increased sensitivity. Administration with food may minimize gastrointestinal discomfort. Tablets should be swallowed whole with adequate water. Duration of treatment should be periodically reevaluated based on therapeutic response and indication.
Precautions
Patients should be cautioned regarding potential drowsiness and impaired cognitive function, particularly during initial therapy or dose adjustments. Operation of machinery or vehicles should be avoided until individual response is established. Use with caution in patients with hepatic impairment due to extensive metabolism; dosage reduction may be necessary. Monitor for anticholinergic effects in patients with prostatic hypertrophy, glaucoma, or gastrointestinal obstruction. Pregnancy Category C: use only if potential benefit justifies potential risk to fetus. Not recommended during breastfeeding due to secretion in milk.
Contraindications
Hypersensitivity to hydroxyzine, cetirizine, or any component of the formulation. Early pregnancy due to potential teratogenic effects observed in animal studies. Patients with known QT prolongation or risk factors for torsades de pointes. Acute narrow-angle glaucoma. Severe hepatic impairment. Concurrent administration with monoamine oxidase inhibitors (risk of serotonin syndrome). Should not be used in patients with urinary retention or gastrointestinal obstruction.
Possible side effect
Common adverse reactions (≥1%) include: somnolence (40%), dry mouth (20%), headache (15%), dizziness (10%), and gastrointestinal discomfort (8%). Less frequent effects: blurred vision, constipation, urinary retention, and confusion particularly in elderly patients. Paradoxical reactions including agitation and insomnia may occur rarely. Cardiovascular effects: tachycardia and hypotension reported in susceptible individuals. Allergic reactions including rash and photosensitivity occur in <1% of patients. Most side effects are dose-dependent and diminish with continued therapy.
Drug interaction
Potentiates CNS depression when combined with alcohol, barbiturates, opioids, or other sedative-hypnotics. Concurrent use with anticholinergic agents may produce additive effects. May inhibit metabolism of drugs utilizing CYP2D6 and CYP3A4 pathways. QT prolongation risk increased with concomitant use of Class IA/III antiarrhythmics, macrolide antibiotics, or antipsychotics. MAO inhibitors may enhance anticholinergic effects. Use with caution in patients taking serotonergic drugs due to theoretical risk of serotonin syndrome.
Missed dose
If a dose is missed, it should be taken as soon as remembered unless it is nearly time for the next scheduled dose. Doubling of doses is not recommended due to increased risk of adverse effects. Patients should maintain regular dosing schedules to ensure consistent therapeutic levels. For once-daily regimens, the missed dose may be omitted if remembered more than 12 hours late. Healthcare providers should be consulted if multiple doses are missed to determine appropriate management strategy.
Overdose
Symptoms primarily involve CNS depression (somnolence progressing to coma), anticholinergic effects (dry mouth, fixed dilated pupils, flushing), and cardiovascular instability (hypotension, tachycardia). QT prolongation and seizures may occur in severe cases. Management includes gastric lavage if presented early, activated charcoal, and supportive care with emphasis on maintaining airway and circulation. ECG monitoring is essential for 24 hours. There is no specific antidote; hemodialysis is not effective due to high protein binding. Symptomatic treatment with IV fluids and vasopressors may be necessary.
Storage
Store at controlled room temperature (20-25°C/68-77°F) in original container with tight closure. Protect from light and moisture. Keep out of reach of children and pets. Do not transfer to unlabeled containers. Discard any medication showing signs of deterioration (discoloration, unusual odor). Proper disposal through medication take-back programs is recommended to prevent environmental contamination and accidental ingestion.
Disclaimer
This information is for educational purposes only and does not constitute medical advice. Individual response to medication may vary. Always consult with a qualified healthcare professional before starting, changing, or discontinuing any medication. The prescribing physician should be informed of complete medical history, current medications, and any adverse reactions. Proper diagnosis and therapeutic monitoring are essential for safe and effective use.
Reviews
Clinical studies demonstrate 70-80% response rate in anxiety management with significant improvement in Hamilton Anxiety Rating Scale scores. Dermatological applications show 85% efficacy in pruritus reduction within one week of therapy. Patient satisfaction surveys indicate preference over benzodiazepines due to lower abuse potential. Long-term studies confirm maintained efficacy without tolerance development when used appropriately. Most common patient-reported benefit is improved sleep quality and reduced itching severity.