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► Atarax (hydroxyzine) - Practical Medicine

Atarax (hydroxyzine) - syrup

The name of the preparation Character; dose; package Manufacturer Price 100% Price after refund In which pharmacy?
Atarax syrup; 2 mg / ml; 200 ml UCB Pharma 14.03 Check

Note: reimbursed drug prices are in line with the regulations in force from July 1, 2018.

The preparation contains the substance:hydroxyzine

The drug is available on prescription

What is Atarax ?

The drug has a calming, anxiolytic, hypnotic and antihistamine.

 

What does Atarax contain and how does it work?

The active substance is hydroxyzine, a sedative, anxiolytic and antihistamine. It does not affect the function of the cerebral cortex, whereas its sedative effect is probably related to the inhibition of subcortical activity. Used in anxiety states, it relieves the feeling of danger, anxiety and reduces muscle tone. In people with anxiety disorders and insomnia, it increases the total sleep time, shortens waking periods at night and time of falling asleep. It does not induce memory disorders, after discontinuation of use there are no withdrawal symptoms. It has an antihistamine effect, blocks histamine type 1 (H1) receptors. It reduces the reaction caused by the action of histamine, as well as pruritus in various forms of urticaria, eczema and dermatitis. It has little affinity for muscarinic and Dopamine receptors. It also shows antiemetic activity.

After oral administration, hydroxyzine is well absorbed, its sedative effect occurs after 5-10 minutes when using syrup and after 30-45 minutes when using tablets, and the maximum concentration is obtained within 2 hours after taking the preparation. Hydroxyzine is excreted via the kidneys, mainly in the form of metabolites.

 

When to use Atarax?

The preparation is indicated for use in the following cases:

• symptomatic treatment of anxiety in adults

• symptomatic treatment of pruritus

• premedication before surgery.

When not to use this preparation?

Unfortunately, even if there are indications to use the preparation, it can not always be used. You must not use the product if you are allergic (you are hypersensitive) to any of the ingredients or to Cetirizine , other piperazine derivatives, aminophylline or ethylenediamine.

Contraindications to the use of the preparation are also:

• porphyria

• congenital or acquired prolongation of the QT interval in the ECG record

• risk factors for QT prolongation in the ECG, including: cardiovascular diseases, electrolyte disturbances (hypokalemia, hypomagnesaemia), sudden family history of cardiac death, significant reduction in heart rate (bradycardia), use of drugs that may prolong the QT interval and / or cause cardiac arrhythmiastorsade de pointes.

Contraindication is contraindicated in pregnant women or during breastfeeding.

Take special care with Atarax?

Certain diseases and other circumstances may constitute a contraindication to use or indication to change the dosage of the preparation. In some situations it may be necessary to carry out specific check-ups.

Take special care:

• in people with liver failure and / or moderate or severe kidney failure; your doctor will probably recommend lower doses

• in people with a reduced convulsive threshold, especially in children (children are more susceptible to adverse reactions of the central nervous system, including convulsions).

Due to the anticholinergic (cholinolytic) activity of hydroxyzine, caution should be exercised in:

• with closed-angle glaucoma

• with impaired urinary outflow from the bladder

• with reduced gastrointestinal motility

• with muscle fatigue (myasthenia gravis)

• with dementia.

The doctor will adjust the dosage accordingly if you are taking anticholinergic or central nervous system depression at the same time.

Avoid drinking alcohol while taking the drug.

The use of hydroxyzine may be associated with the occurrence of QT prolongation in the ECG and the occurrence of life-threatening cardiac arrhythmiastorsade de pointes. This particularly applies to patients with risk factors, such as electrolyte abnormalities or the use of other drugs that may prolong the QT interval. Taking the preparation by patients from this group is contraindicated.

Hydroxyzine should be used at the lowest effective dose for the shortest possible time. If you have any cardiac arrhythmias, consult a doctor immediately.

The preparation is not recommended for the elderly. In this group of patients, hydroxyzine excretion is reduced and the risk of side effects is increased. Elderly people may experience cognitive decline.

To avoid the effects of the preparation on the results of allergy tests and the methacholine bronchial challenge test, the use of hydroxyzine should be discontinued at least 5 days prior to these tests (after consultation with a physician).

Additional information about the other ingredients of the preparation:

• the product contains sucrose; people with hereditary disorders associated with fructose intolerance, Glucose -galactose malabsorption or sucrase-isomaltase deficiency should not use this preparation

• the product contains sucrose; caution should be exercised in patients with diabetes

• the product contains a small amount of ethanol (0.1%); this should be taken into account in people with alcoholism, children, high-risk people, i.e. people with liver disease or epilepsy

• the product contains sodium benzoate, which may increase the risk of jaundice in newborns.

 

Does this preparation affect the ability to drive vehicles?

Persons using the preparation should not drive or operate machines / machines. Hydroxyzine has a significant influence on the ability to drive vehicles and operate equipment / machines.

 

Dosage of Atarax

The preparation is in the form of a syrup. It is intended for oral use. Do not exceed the recommended doses, because it will not increase the effectiveness of the drug and may harm your health and life. If you have any doubts about the use of the preparation, consult your doctor.

Hydroxyzine should be used at the lowest effective dose for the shortest possible time.

Adults:

Symptomatic treatment of anxiety: 50 mg daily in 2-3 divided doses; in severe cases, the doctor may increase the dose to 100 mg daily.

Symptomatic treatment of pruritus: initially 25 mg at bedtime, as required, your doctor may recommend increasing the dose gradually to 25 mg 3-4 times a day.

Premedication before surgery: 50-100 mg once.

In adults and children weighing more than 40 kg, the maximum daily dose is 100 mg.

In the elderly, it is recommended to reduce the initial dose by half and in patients with renal or hepatic impairment adjust the dosage (the doctor will recommend a corr esponding dose reduction).

In the elderly, the maximum dose is 50 mg per day.

 

Children and youth:

Symptomatic treatment of pruritus: children from 12 months of age 1-2 mg / kg body weight per day in divided doses.

Premedication before surgery: 0.6 mg / kg body weight in a single dose.

For children weighing up to 40 kg, the maximum daily dose is 2 mg / kg body weight per day. In children with a body weight of more than 40 kg, the maximum daily dose is 100 mg.

 

Can Atarax be used during pregnancy and breastfeeding?

During pregnancy, do not use any medicine without consulting your doctor!

It is very important that you consult a physician before taking any medicine during pregnancy or breastfeeding and explain beyond any doubt the potential risks and benefits of using the medicine. If you are pregnant or planning to become pregnant, please inform your prescribing physician about this medicine.

The use of the preparation in pregnant women and in women during breast-feeding is contraindicated.

 

Can I use other preparations in parallel?

Tell your doctor about all medicines you have recently taken, including those that are over the counter.

The use of hydroxyzine and drugs that may prolong the QT interval and / or cause cardiac arrhythmias is contraindicatedtorsade de pointessuch as, for example, class Ia and III antiarrhythmics (including quinidine, disopyramide, Amiodarone , sotalol, dofetilide, ibutilide), antipsychotics (e.g. Haloperidol , thioridazine, pimozide, mesoridazine), macrolide antibiotics (e.g. Erythromycin , Clarithromycin ) , quinolones (eg Ciprofloxacin , Levofloxacin , moxifloxacin), some antihistamines, antimalarial drugs (eg mefloquine), ketoconazole, pentamidine, donepezil, some antidepressants (eg citalopram , escitalopram), some medicines used in diseases of the digestive system (e.g. prucalopride, cisapride), some oncological drugs (e.g., Tamoxifen , toremifene, vandetanib), methadone.

Caution should be exercised when using hydroxyzine and drugs that reduce heart rate (bradycardia) or decreases in potassium in the blood (hypokalaemia).

Hydroxyzine is metabolised in the liver with the participation of isoenzymes (including CYP 3A4 / 5) of cytochrome P450. Drugs that inhibit liver enzymes may cause an increase in blood levels of hydroxyzine, and drugs that increase the activity of liver enzymes may reduce its concentration.

Hydroxyzine inhibits the activity of the cytochrome P450 2D6 isoenzyme (in higher concentrations it can also inhibit other cytochrome P450 isoenzymes) and its interactions with drugs metabolized by the same enzyme system may occur. It may be necessary for the doctor to adjust the dosage.

Hydroxyzine may increase the effect of:

• anticoagulants of coumarin derivatives (eg Warfarin )

• meperidines

• central nervous system depressants (eg opioid analgesics, barbiturates, sedatives and hypnotics)

• anticholinergic activity: antihistamines, neuroleptics and antidepressants.

Alcohol increases the effect of hydroxyzine. You should not drink alcohol during treatment. Hydroxyzine is metabolised by alcohol dehydrogenase.

Hydroxyzine may reduce the effects of betahistine and cholinesterase inhibitors.

Hydroxyzine used with adrenergics (eg adrenaline) may reduce their effect on blood pressure.

The simultaneous use of hydroxyzine with monoamine oxidase inhibitors (iMAO) and drugs with a cholinolytic effect should be avoided.

Hydroxyzine reduces the anticonvulsant effect of phenytoin.

Cimetidine increases the concentration of hydroxyzine in the blood.

Hydroxyzine used with tricyclic antidepressants may exacerbate their cardiotoxic effects, which may lead to myocardial damage and cardiomyopathy.

To avoid the effects of the preparation on the results of allergy tests and the methacholine bronchial challenge test, the use of hydroxyzine should be discontinued at least 5 days prior to these tests (after consultation with a physician).

 

What side effects can occur?

Like all medicines, Atarax can also cause side effects, although they will not occur in all patients who are taking this medicine. Remember that the expected benefits of using the drug are usually greater than the damage resulting from the occurrence of side effects.

Very often: drowsiness. Often or uncommon may occur: dry mouth, nausea, headache, dizziness, excessive sedation, insomnia, tremors, agitation, confusion, fatigue, weariness, malaise and fever. Rarely or very rarely: increased heart rate (tachycardia), disturbed eye accomodation, blurred vision, constipation, vomiting, dyskinesia, convulsions, confusion, hallucinations, urinary retention, hypotension, bronchospasm, hypersensitivity reactions, pruritus, rash, urticaria, angioneurotic edema , profuse sweating, anaphylactic shock, severe skin reactions (acute generalized pustular exanthema, erythema multiforme, Stevens and Johnson syndrome).

In addition, possible side effects for which the frequency of their occurrence has not been determined: hematopoietic disorders with thrombocytopenia and blood coagulation disorders, headache, irritability, dysfunction, fever, cognitive decline in the elderly, worsening of liver function (abnormal results liver function tests), prolongation of the ECG QT interval, cardiac arrhythmiastorsade de pointes, involuntary movements, including seizures (after using doses higher than recommended).

 

Other preparations on the Polish market containing hydroxyzine

Atarax (coated tablets)
Hydroxyzine Orion (coated tablets)
Hydroxyzinum Adamed (coated tablets)
Hydroxyzinum Aflofarm (syrup)
Hydroxyzinum Alvogen (syrup)
Hydroxyzinum Alvogen (coated tablets)
Hydroxyzinum Espefa (syrup)
Hydroxyzinum Espefa (coated tablets)
Hydroxyzinum Hasco (syrup)
Hydroxyzinum Hasco (coated tablets)
Hydroxyzinum Polfarmex (syrup)
Hydroxyzinum Polfarmex (coated tablets)
Hydroxyzinum PPH (coated tablets)
Hydroxyzinum Teva (solution for injection)
Hydroxyzinum VP (syrup)
Hydroxyzinum VP (coated tablets)