Hydroxyzine Syrup Dosing and Administration in Pediatric Patients
For pediatric patients, hydroxyzine syrup should be dosed as follows: children under 6 years should receive 50 mg daily in divided doses, while children over 6 years should receive 50-100 mg daily in divided doses. 1
Dosage by Indication
Anxiety and Tension
- Children under 6 years: 50 mg daily in divided doses 1
- Children over 6 years: 50-100 mg daily in divided doses 1
Pruritus and Allergic Conditions
- Children under 6 years: 50 mg daily in divided doses 1
- Children over 6 years: 50-100 mg daily in divided doses 1
Premedication/Sedation
- 0.6 mg/kg of body weight 1
- For dental procedures, 3.7 mg/kg has been studied and found effective when combined with nitrous oxide sedation 2
Administration Considerations
- Hydroxyzine syrup formulation facilitates administration to children who may have difficulty swallowing tablets 3
- The medication can be divided into multiple doses throughout the day for better tolerance and efficacy 1
- For pruritus in atopic dermatitis, studies have shown that 0.7 mg/kg three times daily is as effective as higher doses (1.4 mg/kg three times daily) with significantly less sedation 4
- Peak serum concentration typically occurs at approximately 2 hours after oral administration 4
Special Considerations
- Dosage should be reduced by half in patients with renal impairment 5
- Avoid use in patients with severe renal impairment (creatinine clearance <10 mL/min) 5
- Avoid use in patients with severe hepatic impairment due to increased risk of sedating effects 5
- Adjust dosage according to the patient's response to therapy 1
Safety Profile
- Most common adverse effects are drowsiness and dry mouth 6
- Hydroxyzine is generally considered safe when used at appropriate dosages 6
- Monitor for excessive sedation, especially when combined with other central nervous system depressants 6
- The elimination half-life increases with age in pediatric patients (mean 7.1 ± 2.3 hours), which may affect dosing frequency in older children 4
Monitoring
- Assess level of sedation during therapy, particularly when used for procedural sedation 6
- Be aware of potential respiratory complications when hydroxyzine is used in combination with other sedative medications 6
- The antipruritic effects can last up to 24 hours after administration, with peak effect between 2-12 hours 4
When administering hydroxyzine syrup to pediatric patients, always consider the child's age, weight, and clinical condition to determine the appropriate dose within the recommended ranges.