Hydroxyzine Suspension

Hydroxyzine Suspension
Usage
Hydroxyzine suspension is an oral liquid formulation of a first-generation antihistamine with antihistaminic, anxiolytic, and sedative properties. It is commonly used for both allergic conditions and short-term anxiety relief.
It may be prescribed for:
• Allergic conditions (e.g., urticaria, pruritus, allergic dermatitis)
• Itching (pruritus) associated with various conditions
• Anxiety and tension (short-term management)
• Sedation, including pre-procedural use
• Other practitioner-directed uses where a liquid formulation is preferred

Dosage
Dosage should be determined by the prescribing practitioner based on the patient’s age, weight, condition, and response to treatment.
Typical dosing considerations include:
• Administered two to four times daily, depending on indication
• Paediatric dosing is typically weight-based (mg/kg/day)
• The suspension should be shaken well before use
• May be taken with or without food
The lowest effective dose should be used to minimise sedation and other side effects.

Mechanisms of Action
Hydroxyzine is an H₁ receptor antagonist with additional central nervous system effects.
Its mechanisms include:
Blockade of H₁ histamine receptors
Hydroxyzine inhibits histamine action, reducing allergic symptoms such as itching, redness, and swelling.
Central sedative effects
It crosses the blood–brain barrier and exerts sedative and anxiolytic effects via central nervous system activity.
Anticholinergic activity
Hydroxyzine has mild anticholinergic effects, contributing to its drying and sedative properties.

Contraindications
Hydroxyzine should not be used in patients with:
• Hypersensitivity to hydroxyzine, cetirizine, or related compounds
• Early pregnancy (as per clinical guidance)
• Known prolonged QT interval or significant cardiac arrhythmias
• Allergy to any component of the formulation

Precautions
Hydroxyzine should be used with caution in patients with:
• Cardiovascular disease, particularly QT prolongation risk
• Elderly patients, who may be more sensitive to sedation and anticholinergic effects
• Hepatic or renal impairment
• Glaucoma or urinary retention, due to anticholinergic effects
Additional considerations include:
• May cause drowsiness, dizziness, and impaired alertness
• Avoid alcohol and other CNS depressants
• Use caution when driving or operating machinery
• Possible side effects include:
• Dry mouth
• Blurred vision
• Constipation
• Patients should seek medical advice if they experience palpitations, severe drowsiness, or confusion

Storage
• Store below 25°C unless otherwise directed
• Keep the suspension in a tightly closed container
• Shake well before use
• Protect from heat, moisture, and direct light
• Some compounded formulations may have a limited shelf life
• Keep out of reach of children and pets
Patients should follow the specific storage instructions provided on the dispensing label supplied by the pharmacy.