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: adults, 50 to 100 mg q.i.d. ; For use in the management of pruritus due to allergic conditions such as chronic urticaria and atopic and contact dermatoses and in histamine-mediated pruritus: adults, 25 mg t.i.d. or q.i.d. As a sedative when used as a premedication and following general anesthesia: 50 to 100 mg for adults
The recommended dosing for hydroxyzine in adults is:
- 50 to 100 mg q.i.d. for symptomatic relief of anxiety and tension
- 25 mg t.i.d. or q.i.d. for management of pruritus due to allergic conditions
- 50 to 100 mg as a sedative when used as a premedication and following general anesthesia 1
From the Research
For adults, hydroxyzine is typically dosed at 25-100 mg orally 3-4 times daily as needed, with a recommended starting dose of 25 mg for mild symptoms, and a maximum daily dose of 400 mg. The dosing of hydroxyzine can vary depending on the severity of the condition being treated, with more severe conditions requiring higher doses 2. It is essential to note that elderly patients should start with lower doses, typically 10-25 mg, due to increased sensitivity to anticholinergic effects. Hydroxyzine is available in multiple formulations, including tablets, capsules, and syrup, and works by blocking H1 histamine receptors, which can cause sedative properties, so patients should be cautious about driving or operating machinery after taking it 3.
Some key points to consider when dosing hydroxyzine include:
- The medication can cause common side effects such as dry mouth, drowsiness, and constipation
- It should be taken with caution in patients with certain conditions like narrow-angle glaucoma, prostatic hypertrophy, or bladder obstruction
- The onset of action is relatively quick, usually within 15-30 minutes, with effects lasting 4-6 hours, making it useful for both acute allergic reactions and anxiety symptoms
- Bedtime dosing of hydroxyzine can help mitigate adverse subjective symptoms and reaction time degradation, while maintaining skin H1-receptor antagonism the following morning 3
It is crucial to prioritize the patient's safety and adjust the dosing regimen accordingly, taking into account the potential risks and benefits of hydroxyzine treatment, as well as the individual patient's response to the medication 4, 5, 2.