Hydroxyzine (Atarax®) is an antihistamine medication primarily prescribed to treat anxiety and itching. What are the risks ? The sleepiness ? Heart trouble? What to replace it with?
No, hydroxyzine is still currently marketed in France. The drugs that contain it are:
Taking hydroxyzine is associated with a risk of drowsiness. Increased vigilance is therefore required for people who have to drive a vehicle or use a machine at the risk of causing an accident.
Hydroxyzine exposes the person taking it to anticholinergic effects (urinary retention, constipation, visual disturbances, tachycardia). Other effects like a weight gain, fever, confusion, low blood pressure are also reported. Moreover, nausea, vomiting and liver damage (hepatitis, increased enzymes) may occur. More rarely, hydroxyzine is responsible hallucinations, tremors and severe allergic reactions.
Hydroxyzine should not be taken if allergy to one of the components of the medicinal product or to one of the medicinal products of the same chemical family (derivatives of piperazine): cetirizine, levocetirizine, meclozine (Agyrax®). Similarly, the use of hydroxyzine is prohibited in a patient with prolongation of the QT interval (visible on the electrocardiogram) or having known risk factors for this cardiac abnormality (family history, cardiovascular pathology, potassium deficiency). In addition, hydroxyzine is contraindicated in the following cases:
Hydroxyzine should not be administered concomitantly with a drug that prolongs the QT interval at the risk of inducing torsades de pointes manifested by an acceleration of the heart rate. In the most severe cases, this phenomenon can lead to the death of the person. This dangerous association is therefore formally contraindicated. Drugs causing QT interval prolongation are mainly:
Depending on the indication in which it is prescribed, hydroxyzine will be replaced by different drugs:
► In the treatment of minor anxiety in adults, drugs that can be taken instead of hydroxyzine are Stresam® (another anxiolytic) or a phytotherapy product such as Euphytosis®, Spasmine®. Note that benzodiazepines (Xanax®, Seresta®, etc.) are reserved for much more severe anxieties.
► In the treatment of itching, it is possible to use another antihistamine such as cetirizine, desloratadine, loratadine.
► In the management of insomnia in children over 3 years old, it is possible to replace hydroxyzine with Théralène® in tablets from 6 years old or in oral solution for children over 20 kg. The use of herbal medicines can also be considered: Quiétude®, Sédatif PC® (from 1 year) and Euphytose®, Spasmine® (from 12 years old).
– Public drug database
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