Sedating H1 antihistamine
Hydroxyzine hydrochloride
Brand names: Atarax, Ucerax
Adult dose
Dose: Anxiety: 50–100mg QDS (max 100mg/dose, max 300mg/day in adults; lower in elderly). Pruritus: 25mg nocte, increase to 25mg TDS-QDS
Route: PO
Frequency: TDS-QDS
Clinical pearls
- MHRA: lowest effective dose, max 100mg/day in elderly, contraindicated with QT-prolonging drugs
- Pruritus and short-term anxiety
Contraindications
- Long QT interval / risk factors for QT prolongation
- Hypersensitivity
- Pregnancy/breastfeeding
- Acute porphyria
Side effects
- Sedation
- Dry mouth
- QT prolongation (MHRA)
- Anticholinergic effects
- Confusion in elderly
Interactions
- QT-prolonging drugs
- CNS depressants
- Anticholinergics
Monitoring
- ECG if cardiac risk
Reference: BNF; MHRA Drug Safety Update; https://bnf.nice.org.uk/drugs/hydroxyzine-hydrochloride/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Acute Behavioural Disturbance / Rapid Tranquillisation · RCEM 2022; RCPsych 2022; NICE NG10
- Self-Harm Presentation · NICE NG225 (2022)
- Capacity Assessment (Mental Capacity Act) · MCA 2005; Code of Practice
- Acute Psychosis Management · NICE CG178 2014
- Depression Management · NICE CG90 2022
- Lithium Therapy Monitoring · NICE CG185 / BNF