II. Mechanism
- First Generation Antihistamine
III. Adverse Effects
- See Anticholinergic Toxicity
- Sedation, or, in children, paradoxical excitability
- Worsens Benign Prostatic Hyperplasia
- Worsens Glaucoma
- Dizziness
- Respiratory depression
- Tachycardia
- Seizures
-
QT Prolongation (and Torsades de Pointes)
- Especially with Hydroxyzine
- Anticholinergic Symptoms
IV. Indications
- Allergic Rhinitis
- Antiemetic
- Anaphylaxis
- Acute Urticaria
- Chronic Urticaria
- Anti-pruritic
- Suppresses itching, and reduces lesions
- Does not completely eradicate
- Hydroxyzine (Atarax) is most potent Antihistamine for Pruritus
V. Preparations: Antihistamine
- See Diphenhydramine (Benadryl)
- Chlorpheniramine (Chlor-Trimeton, Pregnancy Category B, approved for age over 6 years)
- Dose: 4 mg orally every 4 to 6 hours as needed
- Clemastine (Tavist)
- Dose: 1.34 mg orally twice daily as needed
- Cyproheptadine (Periactin)
- Dose: 4 mg orally three times daily as needed
-
Diphenhydramine (Benadryl, Pregnancy Category B, approved for age over 6 years)
- Adult: 25-50 mg PO/IV/IM every 6 hours
- Child: 5 mg/kg/day divided every 6 hours (12.5 mg/5 ml)
- Hydroxyzine (Atarax, Vistaril)
- Dose: 0.5 mg/kg up to 25-50 mg orally or intramuscular every 4-6 hours as needed
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Related Studies
| cyproheptadine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| CYPROHEPTADINE 2 MG/5 ML SOLN | Generic | $0.05 per ml |
| CYPROHEPTADINE 2 MG/5 ML SYRUP | Generic | $0.05 per ml |
| CYPROHEPTADINE 4 MG TABLET | Generic | $0.10 each |
| hydroxyzine (on 12/21/2022 at Medicaid.Gov Survey of pharmacy drug pricing) | ||
| HYDROXYZINE 10 MG/5 ML SOLN | Generic | $0.07 per ml |
| HYDROXYZINE 10 MG/5 ML SYRUP | Generic | $0.07 per ml |
| HYDROXYZINE HCL 10 MG TABLET | Generic | $0.04 each |
| HYDROXYZINE HCL 25 MG TABLET | Generic | $0.05 each |
| HYDROXYZINE HCL 50 MG TABLET | Generic | $0.09 each |
| HYDROXYZINE PAM 100 MG CAP | Generic | $0.42 each |
| HYDROXYZINE PAM 25 MG CAP | Generic | $0.08 each |
| HYDROXYZINE PAM 50 MG CAP | Generic | $0.10 each |