Roxyzin

Indications

Roxyzin Hydrochloride is prescribed for:

• Providing symptomatic relief for anxiety and tension linked with psychoneurosis, as well as acting as an adjunctive treatment for organic diseases where anxiety symptoms are present.
• Managing pruritus (itching) caused by allergic conditions such as chronic urticaria, atopic dermatitis, contact dermatitis, and histamine-related pruritus.
• Serving as a sedative when used as premedication or following general anesthesia.

Note: The long-term effectiveness of Roxyzin for managing anxiety (>4 months) has not been established through extensive clinical trials. Regular assessment by a physician is recommended to evaluate its continued suitability for individual patients.

Use as directed by a registered healthcare provider.

Pharmacology

Hydroxyzine Hydrochloride is a non-sedating anxiolytic antihistamine, classified as a piperazine derivative and an H1 receptor antagonist. Unlike cortical depressants, Hydroxyzine’s mechanism of action likely involves suppressing activity in specific subcortical regions of the central nervous system. It also exhibits primary skeletal muscle relaxation and has demonstrated bronchodilator, antihistamine, and mild analgesic effects in clinical settings. An antiemetic effect has also been confirmed through both the apomorphine and veriloid tests.

The drug is swiftly absorbed via the gastrointestinal tract, with noticeable effects typically within 15 to 30 minutes after oral intake.

Dosage & Administration

For Anxiety and Tension Relief:

• Adults: 50–100 mg, 4 times a day.
• Children (>6 years): 50–100 mg (5–10 teaspoonfuls) daily, divided into doses.
• Children (<6 years): 50 mg (5 teaspoonfuls) daily, divided into doses.

For Pruritus from Allergic Conditions:

• Adults: 25 mg, 3–4 times daily.
• Children (6+ years): 50–100 mg (5–10 teaspoonfuls) daily, divided into doses.
• Children (<6 years): 50 mg (5 teaspoonfuls) daily, divided into doses.

As a Sedative (Pre-Anesthesia and Post-Anesthesia):

• Adults: 50–100 mg.
• Children: 0.6 mg/kg of body weight.

Use only as per the guidance of a registered healthcare provider.

Interactions

Roxyzin may enhance the effects of Meperidine and barbiturates, requiring dosage adjustments when used together, particularly in pre-anesthetic therapy. No interactions with Atropine or other belladonna alkaloids have been observed. Hydroxyzine does not interfere with Digitalis, making it safe for concurrent use. However, combining Roxyzin with monoamine oxidase inhibitors (MAOIs) should be avoided.

Contraindications

Hydroxyzine should not be used in patients with known hypersensitivity to Hydroxyzine or any of its components.

Side Effects

Common side effects are generally mild and short-lived. These may include drowsiness, headache, psychomotor impairment, and antimuscarinic effects such as dry mouth, blurred vision, urinary retention, and digestive issues. Other rare but serious side effects can include hypotension, palpitations, arrhythmias, dizziness, confusion, depression, sleep disturbances, tremors, seizures, allergic reactions (including bronchospasm, angioedema, anaphylaxis), rashes, photosensitivity, liver dysfunction, and glaucoma.

Pregnancy & Lactation

Due to insufficient clinical data on its safety during early pregnancy, Hydroxyzine is contraindicated in early pregnancy. It is also unknown whether Hydroxyzine passes into breast milk, so it should not be administered to breastfeeding mothers unless deemed absolutely necessary by a healthcare professional.

Precautions & Warnings

When using Roxyzin in combination with CNS depressants like narcotics, non-narcotic analgesics, or barbiturates, the dosage of these agents should be reduced accordingly to prevent excessive sedation. Caution is advised regarding the potential for drowsiness, and patients should refrain from driving or operating heavy machinery. Alcohol should be avoided, as its effects may be amplified when used with Roxyzin.

Use in Special Populations

• Renal Impairment: The usual dose should be halved in patients with impaired renal function.
• Elderly Patients: It is recommended to start with a reduced dose, typically half the standard dose, due to prolonged drug action in the elderly.

Overdose Effects

The primary symptom of Roxyzin overdose is hypersedation. If overdose is suspected, induce vomiting (if not already spontaneous), perform gastric lavage, and provide supportive care, including monitoring vital signs. Hypotension can be managed with IV fluids and medications like Levarterenol or Metaraminol. Avoid using Epinephrine as Roxyzin can counteract its effect.

There is no specific antidote for Roxyzin overdose, and hemodialysis is unlikely to be effective. However, if other drugs like barbiturates are involved, hemodialysis may be appropriate.

Therapeutic Class

Sedating Antihistamine

Storage Instructions

Store in a cool, dry place away from light and out of children’s reach.