Codeine; Phenylephrine; Promethazine: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence.
Moderate Caution is recommended if hydroxyzine is administered with promethazine due to the potential for additive QT prolongation and risk of torsade de pointes TdP. In addition, additive anticholinergic effects and CNS depression may also occur. Promethazine is associated with a possible risk for QT prolongation. Codeine; Promethazine: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence.
Crizotinib: Major Avoid coadministration of crizotinib with hydroxyzine due to the risk of QT prolongation. An interruption of therapy, dose reduction, or discontinuation of therapy may be necessary for crizotinib if QT prolongation occurs. Crizotinib has been associated with concentration-dependent QT prolongation.
Cyclobenzaprine: Moderate Cyclobenzaprine and sedating antihistamines such as hydroxyzine both exhibit anticholinergic activity, and anticholinergic side effects can be additive. Monitor for anticholinergic-related effects such as constipation and urinary retention.
Dosage adjustments of either or both drugs may be necessary. Daratumumab; Hyaluronidase: Minor H1-blockers antihistamines , when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase. Patients receiving these medications may require larger amounts of hyaluronidase for equivalent dispersing effect.
Dasatinib: Moderate Monitor for evidence of QT prolongation and torsade de pointes TdP if hydroxyzine and dasatinib are coadministered. In vitro studies have shown that dasatinib has the potential to prolong the QT interval. Degarelix: Moderate Consider whether the benefits of androgen deprivation therapy outweigh the potential risks in patients receiving hydroxyzine. Androgen deprivation therapy i.
Postmarketing data indicate that hydroxyzine causes QT prolongation and torsade de pointes TdP. Desloratadine: Minor Although desloratadine is considered a 'non-sedating' antihistamine, dose-related sedation has been noted.
For this reason, it would be prudent to monitor for drowsiness during concurrent use of desloratadine with CNS depressants such as other H1-blockers. Desloratadine; Pseudoephedrine: Minor Although desloratadine is considered a 'non-sedating' antihistamine, dose-related sedation has been noted. Deutetrabenazine: Moderate Caution is recommended if hydroxyzine is administered with deutetrabenazine.
Deutetrabenazine may prolong the QT interval, but the degree of QT prolongation is not clinically significant when deutetrabenazine is administered within the recommended dosage range. Also, monitor for excessive sedation and somnolence during coadministration of hydroxyzine and deutetrabenazine. Dexmedetomidine: Moderate Co-administration of dexmedetomidine with sedating antihistamines is likely to lead to an enhancement of CNS depression.
Dextroamphetamine: Moderate Amphetamines may pharmacodynamically counteract the sedative properties of some antihistamines, such as the sedating H1-blockers i.
Dextromethorphan; Quinidine: Major Caution is recommended if hydroxyzine is administered with quinidine due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Quinidine administration is associated with QT prolongation and TdP. Dihydrocodeine; Guaifenesin; Pseudoephedrine: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence.
Diphenhydramine; Hydrocodone; Phenylephrine: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Disopyramide: Major Disopyramide should be used cautiously and with close monitoring with hydroxyzine.
Disopyramide administration is associated with QT prolongation and TdP. In addition, the anticholinergic effects of hydroxyzine are moderate and may be enhanced when combined with other medications with anticholinergic effects, such as disopyramide.
Antimuscarinic effects might be seen not only on GI smooth muscle, but also on bladder function, the eye, and temperature regulation. Dofetilide: Major Coadministration of dofetilide and hydroxyzine is not recommended as concurrent use may increase the risk of QT prolongation.
Dolasetron: Moderate Caution is recommended if hydroxyzine is administered with dolasetron due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Dolutegravir; Rilpivirine: Moderate Caution is recommended if hydroxyzine is administered with rilpivirine due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Donepezil: Moderate Caution is recommended if hydroxyzine is administered with donepezil due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Case reports indicate that QT prolongation and TdP can occur during donepezil therapy. Donepezil; Memantine: Moderate Caution is recommended if hydroxyzine is administered with donepezil due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Dronabinol: Moderate Use caution if coadministration of dronabinol with antihistamines is necessary. Concurrent use of dronabinol, THC with antihistamines may result in additive drowsiness, hypertension, tachycardia, and possibly cardiotoxicity.
Dronedarone: Contraindicated Coadministration of dronedarone with hydroxyzine is contraindicated due to the risk of additive QT prolongation and torsade de pointes TdP. Dronedarone administration is associated with a dose-related increase in the QTc interval. The increase in QTc is approximately 10 milliseconds at doses of mg twice daily the FDA-approved dose and up to 25 milliseconds at doses of mg twice daily. Droperidol: Major Droperidol should not be used in combination with any drug known to have potential to prolong the QT interval, such as hydroxyzine.
If coadministration cannot be avoided, use extreme caution; initiate droperidol at a low dose and increase the dose as needed to achieve the desired effect. Droperidol administration is associated with an established risk for QT prolongation and torsade de pointes TdP. Some cases have occurred in patients with no known risk factors for QT prolongation and some cases have been fatal. Efavirenz: Moderate Consider alternatives to efavirenz when coadministering with hydroxyzine as concurrent use may increase the risk of QT prolongation.
QTc prolongation has been observed with the use of efavirenz. Efavirenz; Emtricitabine; Tenofovir: Moderate Consider alternatives to efavirenz when coadministering with hydroxyzine as concurrent use may increase the risk of QT prolongation. Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate: Moderate Consider alternatives to efavirenz when coadministering with hydroxyzine as concurrent use may increase the risk of QT prolongation.
Eliglustat: Moderate Caution is recommended if hydroxyzine is administered with eliglustat due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Emtricitabine; Rilpivirine; Tenofovir alafenamide: Moderate Caution is recommended if hydroxyzine is administered with rilpivirine due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate: Moderate Caution is recommended if hydroxyzine is administered with rilpivirine due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Encorafenib: Major Avoid coadministration of encorafenib and hydroxyzine due to QT prolongation. If concurrent use cannot be avoided, monitor ECGs for QT prolongation and monitor electrolytes; correct hypokalemia and hypomagnesemia prior to treatment. Encorafenib is associated with dose-dependent prolongation of the QT interval. Entacapone: Moderate COMT inhibitors should be given cautiously with other agents that cause CNS depression, including sedating H1-blockers, due to the possibility of additive sedation.
Entrectinib: Major Avoid coadministration of entrectinib with hydroxyzine due to the risk of QT prolongation. Entrectinib has been associated with QT prolongation. Eribulin: Major Monitor ECG if eribulin is administered with hydroxyzine as coadministration may increase the risk for additive QT prolongation and torsade de pointes TdP. Eribulin has been associated with QT prolongation. Erythromycin: Major Caution is recommended if hydroxyzine is administered with erythromycin due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Both hydroxyzine and erythromycin have been associated with QT prolongation and TdP. Erythromycin; Sulfisoxazole: Major Caution is recommended if hydroxyzine is administered with erythromycin due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Escitalopram: Moderate Caution is recommended if hydroxyzine is administered with escitalopram due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Escitalopram has also been associated with a risk of QT prolongation and TdP. Esketamine: Major Closely monitor patients receiving esketamine and hydroxyzine for sedation and other CNS depressant effects. Instruct patients who receive a dose of esketamine not to drive or engage in other activities requiring alertness until the next day after a restful sleep.
Eszopiclone: Moderate A reduction in the dose of eszopiclone and concomitantly administered CNS depressants, such as sedating H1-blockers, should be considered to minimize additive sedative effects.
In addition, the risk of next-day psychomotor impairment is increased during co-administration of eszopiclone and other CNS depressants, which may decrease the ability to perform tasks requiring full mental alertness such as driving. Alcohol consumption may result in additive CNS depression.
Etomidate: Minor Because sedating H1-blockers cause sedation, an enhanced CNS depressant effect may occur when they are combined with general anesthetics. Ezogabine: Moderate Caution is recommended if hydroxyzine is administered with ezogabine due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
In addition, ezogabine has caused urinary retention requiring catheterization in some cases. The anticholinergic effects of hydroxyzine on the urinary tract may be additive. Additive sedation or other CNS effects may also occur. Ezogabine has been associated with QT prolongation.
Fenfluramine: Major Avoid coadministration of hydroxyzine with fenfluramine due to the risk of additive CNS depression. If CNS depressants are administered concomitantly with hydroxyzine, reduce the dosage. Fentanyl: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Fingolimod: Moderate Caution is recommended if hydroxyzine is administered with fingolimod due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Fingolimod initiation results in decreased heart rate and may prolong the QT interval. Fingolimod has not been studied in patients treated with drugs that prolong the QT interval, but drugs that prolong the QT interval have been associated with cases of TdP in patients with bradycardia. Flecainide: Major Caution is recommended if hydroxyzine is administered with flecainide due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Although causality for TdP has not been established for flecainide, patients receiving concurrent drugs that have the potential for QT prolongation may have an increased risk of developing proarrhythmias. Patients should avoid activities requiring full alertness e. Fluconazole: Moderate Caution is recommended if hydroxyzine is administered with fluconazole due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Fluconazole has also been associated with QT prolongation and rare cases of TdP. Fluoxetine: Moderate Caution is recommended if hydroxyzine is administered with fluoxetine. Coadministration may increase the risk for QT prolongation and torsade de pointes TdP. QT prolongation and TdP have been reported in patients treated with fluoxetine. Fluphenazine: Moderate Caution is recommended if hydroxyzine is administered with fluphenazine due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Fluphenazine is associated with a possible risk for QT prolongation. Fluticasone; Salmeterol: Moderate Caution is recommended if hydroxyzine is administered with long-acting beta-agonists due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Fluticasone; Umeclidinium; Vilanterol: Moderate Caution is recommended if hydroxyzine is administered with long-acting beta-agonists due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Fluticasone; Vilanterol: Moderate Caution is recommended if hydroxyzine is administered with long-acting beta-agonists due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Fluvoxamine: Moderate Caution is recommended if hydroxyzine is administered with fluvoxamine due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Cases of QT prolongation and TdP have been reported during postmarketing use of fluvoxamine. Formoterol: Moderate Caution is recommended if hydroxyzine is administered with long-acting beta-agonists due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Formoterol; Mometasone: Moderate Caution is recommended if hydroxyzine is administered with long-acting beta-agonists due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Foscarnet: Major Avoid use of foscarnet with hydroxyzine due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Both QT prolongation and TdP have been reported during postmarketing use of foscarnet and hydroxyzine. Fospropofol: Minor Because sedating H1-blockers cause sedation, an enhanced CNS depressant effect may occur when they are combined with general anesthetics like fospropofol.
Fostemsavir: Moderate Caution is recommended if hydroxyzine is administered with fostemsavir. Supratherapeutic doses of fostemsavir 2, mg twice daily, four times the recommended daily dose have been shown to cause QT prolongation. Fostemsavir causes dose-dependent QT prolongation.
Gabapentin: Major Initiate gabapentin at the lowest recommended dose and monitor patients for symptoms of sedation and somnolence during coadministration of gabapentin and hydroxyzine.
Concomitant use of gabapentin with hydroxyzine may cause additive CNS depression. Galantamine: Moderate Concurrent use of sedating H1-blockers and galantamine should be avoided if possible. Galantamine inhibits acetylcholinesterase, the enzyme responsible for the degradation of acetylcholine, and improves the availability of acetylcholine. Sedating H1-blockers may exhibit significant anticholinergic activity, thereby interfering with the therapeutic effect of galantamine. Gemifloxacin: Moderate Caution is recommended if hydroxyzine is administered with gemifloxacin due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Gemifloxacin may prolong the QT interval in some patients. The maximal change in the QTc interval occurs approximately 5 to 10 hours following oral administration of gemifloxacin. The likelihood of QTc prolongation may increase with increasing dose of the drug; therefore, the recommended dose should not be exceeded especially in patients with renal or hepatic impairment where the Cmax and AUC are slightly higher.
Gemtuzumab Ozogamicin: Moderate Use gemtuzumab ozogamicin and hydroxyzine together with caution due to the potential for additive QT interval prolongation and risk of torsade de pointes TdP.
If these agents are used together, obtain an ECG and serum electrolytes prior to the start of gemtuzumab and as needed during treatment. Although QT interval prolongation has not been reported with gemtuzumab, it has been reported with other drugs that contain calicheamicin.
Gilteritinib: Moderate Use caution and monitor for evidence of QT prolongation if concurrent use of gilteritinib and hydroxyzine is necessary. Gilteritinib has been associated with QT prolongation. Coadministration has the potential for additive QT effects. Glasdegib: Major Avoid coadministration of glasdegib with hydroxyzine due to the potential for additive QT prolongation. If coadministration cannot be avoided, monitor patients for increased risk of QT prolongation with increased frequency of ECG monitoring.
Glasdegib therapy may result in QT prolongation and ventricular arrhythmias including ventricular fibrillation and ventricular tachycardia. Glycopyrrolate; Formoterol: Moderate Caution is recommended if hydroxyzine is administered with long-acting beta-agonists due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Goserelin: Moderate Caution is recommended if hydroxyzine is administered with goserelin due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Granisetron: Moderate Caution is recommended if hydroxyzine is administered with granisetron due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Granisetron has been associated with QT prolongation. Guaifenesin; Hydrocodone: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Guaifenesin; Hydrocodone; Pseudoephedrine: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Halogenated Anesthetics: Major Caution is recommended if hydroxyzine is administered with halogenated anesthetics due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
In addition, because hydroxyzine causes pronounced sedation, an enhanced CNS depressant effect may occur when it is combined with other CNS depressants including halogenated anesthetics. Halogenated anesthetics can prolong the QT interval. Haloperidol: Moderate Caution is recommended if hydroxyzine is administered with haloperidol due to the potential for additive QT prolongation and risk of torsade de pointes TdP. QT prolongation and TdP have been observed during haloperidol treatment.
Excessive doses particularly in the overdose setting or IV administration of haloperidol may be associated with a higher risk of QT prolongation. Heparin: Minor Antihistamines may partially counteract the anticoagulant actions of heparin, according to the product labels.
However, this interaction is not likely of clinical significance since heparin therapy is adjusted to the partial thromboplastin time aPTT and other clinical parameters of the patient. Histrelin: Moderate Caution is recommended if hydroxyzine is administered with histrelin due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Homatropine; Hydrocodone: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Hyaluronidase, Recombinant; Immune Globulin: Minor H1-blockers antihistamines , when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase.
Hyaluronidase: Minor H1-blockers antihistamines , when given in large systemic doses, may render tissues partially resistant to the action of hyaluronidase.
Hydrocodone: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Hydrocodone; Ibuprofen: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Hydrocodone; Phenylephrine: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence.
Hydrocodone; Potassium Guaiacolsulfonate: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Hydrocodone; Pseudoephedrine: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Hydromorphone: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence.
Hydroxychloroquine: Major Avoid coadministration of hydroxyzine and hydroxychloroquine due to the risk of increased QT prolongation. Hydroxychloroquine prolongs the QT interval.
Ibuprofen; Oxycodone: Major Concomitant use of opioid agonists with hydroxyzine may cause excessive sedation and somnolence. Ibutilide: Major Caution is recommended if hydroxyzine is administered with ibutilide due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Ibutilide administration can cause QT prolongation and TdP; proarrhythmic events should be anticipated.
The potential for proarrhythmic events with ibutilide increases with the coadministration of other drugs that prolong the QT interval. Iloperidone: Major Avoid coadministration of iloperidone with hydroxyzine due to the potential for additive QT prolongation and torsade de pointes TdP. In addition, because hydroxyzine causes pronounced sedation, an enhanced CNS depressant effect may occur when it is combined with other CNS depressants including iloperidone.
Iloperidone has also been associated with QT prolongation. Indacaterol: Moderate Caution is recommended if hydroxyzine is administered with long-acting beta-agonists due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Indacaterol; Glycopyrrolate: Moderate Caution is recommended if hydroxyzine is administered with long-acting beta-agonists due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Inotuzumab Ozogamicin: Major Avoid coadministration of inotuzumab ozogamicin with hydroxyzine due to the potential for additive QT interval prolongation and risk of torsade de pointes TdP. If coadministration is unavoidable, obtain an ECG and serum electrolytes prior to the start of treatment and periodically during treatment.
Inotuzumab has been associated with QT interval prolongation. Ipratropium; Albuterol: Minor Caution is recommended if hydroxyzine is administered with short-acting beta-agonists due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Isocarboxazid: Major Concurrent use of monoamine oxidase inhibitors MAOIs and sedating H1-blockers antihistamines may result in additive sedation, anticholinergic effects, or hypotensive reactions.
Consider alternative therapy to these antihistamines where possible. If alternative combinations are not available, these medications may be used together with close monitoring. Many nonprescription products for coughs, colds, allergy, hay fever, or insomnia contain sedating antihistamines. Patients receiving an MAOI should be counseled that it is essential to consult their health care provider or pharmacist prior to the use of any nonprescription products.
Advise against driving or engaging in other activities requiring mental alertness until patients know how this combination affects them. Itraconazole: Moderate Caution is recommended if hydroxyzine is administered with itraconazole due to the potential for additive QT prolongation and risk of torsade de pointes TdP.
Itraconazole has been associated with prolongation of the QT interval. Ivosidenib: Major Avoid coadministration of ivosidenib with hydroxyzine due to an increased risk of QT prolongation. If concomitant use is unavoidable, monitor ECGs for QTc prolongation and monitor electrolytes; correct any electrolyte abnormalities as clinically appropriate.
An interruption of therapy and dose reduction of ivosidenib may be necessary if QT prolongation occurs. Prolongation of the QTc interval and ventricular arrhythmias have been reported in patients treated with ivosidenib.
Ketamine: Minor Because sedating H1-blockers cause sedation, an enhanced CNS depressant effect may occur when they are combined with general anesthetics. Ketoconazole: Moderate Caution is recommended if hydroxyzine is administered with ketoconazole due to the potential for additive QT prolongation and risk of torsade de pointes TdP. Ketoconazole has been associated with prolongation of the QT interval.
Lansoprazole; Amoxicillin; Clarithromycin: Major Avoid coadministration of clarithromycin with hydroxyzine due to the potential for additive QT prolongation and risk of torsade de pointes TdP. It has ataractic activity. In pharmacological doses it is nontoxic and well tolerated. Intravenous injection in mice and rabbits induces a state of hypotony of limbs.
Cornbleet T. Coronavirus Resource Center. Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy Continue. Twitter Facebook. Error Include a valid email address.
To provide you with the most relevant and helpful information and to understand which information is beneficial, we may combine your e-mail and website usage information with other information we have about you.
If we combine this information with your PHI, we will treat all of that information as PHI, and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of e-mail communications at any time by clicking on the Unsubscribe link in the e-mail.
Our Housecall e-newsletter will keep you up-to-date on the latest health information. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of hydroxyzine injection in children.
Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of hydroxyzine injection in the elderly. However, elderly patients are more likely to have unwanted side effects such as confusion, drowsiness and age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving hydroxyzine injection.
There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding. Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary.
When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take. Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco. The presence of other medical problems may affect the use of this medicine.
0コメント