From the Guidelines
Vistaril (hydroxyzine) should be used with caution due to its potential for sedation, performance impairment, and anticholinergic effects, and second-generation antihistamines are generally preferred over first-generation antihistamines like Vistaril for the treatment of allergic rhinitis. When considering the use of Vistaril, it is essential to weigh the benefits against the potential risks, particularly in certain populations such as older adults, who are more sensitive to its psychomotor impairment effects and are at increased risk for complications like fractures and subdural hematomas caused by falls 1. The medication's side effects, including drowsiness, dry mouth, and dizziness, should also be taken into account, and patients should be advised to avoid alcohol and other central nervous system depressants while taking Vistaril to minimize the risk of increased sedation. Some of the key points to consider when prescribing Vistaril include:
- Its potential for sedative effects, which can be beneficial in some cases, such as sleep induction, but are usually undesirable and potentially dangerous 1
- The risk of performance impairment, which can exist without subjective awareness of drowsiness and can be exacerbated by concomitant use of other CNS-active substances 1
- The potential for anticholinergic effects, including dryness of mouth and eyes, constipation, and an increased risk for provocation of narrow angle glaucoma 1
- The importance of using caution when prescribing Vistaril to older adults and those with certain medical conditions, such as glaucoma or urinary retention 1.
From the FDA Drug Label
For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested. Useful in the management of pruritus due to allergic conditions such as chronic urticaria and atopic and contact dermatoses and in histamine-mediated pruritus As a sedative when used as a premedication and following general anesthesia, hydroxyzine may potentiate meperidine and barbiturates, so their use in pre-anesthetic adjunctive therapy should be modified on an individual basis. The main uses of Vistaril (hydroxyzine) are:
- Anxiety and tension relief in psychoneurosis
- Pruritus management due to allergic conditions
- As a sedative for premedication and post general anesthesia 2