From the Guidelines
I strongly advise against taking hydroxyzine three times a day without consulting your healthcare provider first, as it can cause significant sedation and drowsiness, potentially interfering with daily activities, especially driving or operating machinery. Hydroxyzine is typically prescribed to be taken 3-4 times daily, with dosages ranging from 25-100mg per dose for adults, depending on the condition being treated and individual factors 1. However, the most recent and highest quality study available, from 2017, recommends hydroxyzine 10-25 mg QID, or at bedtime, for managing dermatologic toxicities associated with immune checkpoint inhibitors 1.
The potential risks associated with hydroxyzine, such as sedation, performance impairment, and anticholinergic effects, should be carefully considered, especially in older adults, who are more sensitive to these effects 1. Additionally, the use of hydroxyzine can lead to impaired driving performance, which can be worsened by cellular phone use 1.
Given the potential risks and side effects, it is crucial to consult with your healthcare provider to determine the appropriate dosing schedule for your specific medical condition, age, weight, and other medications you may be taking. Your healthcare provider can help you weigh the benefits and risks of hydroxyzine and determine the best course of treatment for your particular situation.
Some key points to consider when taking hydroxyzine include:
- Starting with a low dose and gradually increasing as needed and under medical supervision
- Avoiding activities that require alertness, such as driving or operating machinery, especially when first starting the medication
- Monitoring for signs of sedation, drowsiness, or other side effects, and reporting them to your healthcare provider
- Considering alternative treatments, such as second-generation antihistamines, which may have fewer side effects 1.
Ultimately, the decision to take hydroxyzine three times a day should be made in consultation with your healthcare provider, taking into account your individual needs and medical history.
From the FDA Drug Label
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.
- The FDA drug label does provide information on the dosing frequency of hydroxyzine.
- According to the label, hydroxyzine can be given t.i.d. (three times a day) for the management of pruritus due to allergic conditions in adults, with a dose of 25 mg.
- Therefore, yes, hydroxyzine can be given three times a day, but the dose and frequency should be adjusted according to the patient's response to therapy 2.
From the Research
Administration of Hydroxyzine
- Hydroxyzine is an antihistamine that can be used to treat various conditions, including urticaria and atopic dermatitis 3.
- According to a study published in Clinical Therapeutics, hydroxyzine can be administered at a dose of 25 mg thrice daily 3.
- This study compared the efficacy and safety of loratadine, hydroxyzine, and placebo in patients with chronic idiopathic urticaria or atopic dermatitis, and found that hydroxyzine was effective in reducing symptoms, but caused more somnolence or sedation compared to loratadine 3.
Considerations for Administration
- The choice of administration frequency and dosage may depend on individual patient needs and pharmacokinetic considerations 4.
- It is essential to consider the potential side effects of hydroxyzine, such as somnolence or sedation, when determining the administration schedule 3.
- There is no direct evidence in the provided studies to suggest that administering hydroxyzine thrice daily is inappropriate, but it is crucial to consult with a healthcare professional to determine the best course of treatment for a specific condition 3.