Hydroxyzine Syrup Dosing for 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 6 years and older should receive 50-100 mg daily in divided doses. 1
Age-Based Dosing Guidelines
- Children under 6 years of age: 50 mg total daily dose, administered in divided doses throughout the day 1
- Children 6 years and older: 50-100 mg total daily dose, administered in divided doses throughout the day 1
- For premedication/sedation: 0.6 mg/kg of body weight 1
Indications for Use in Pediatrics
- Anxiety and tension: Hydroxyzine syrup can be used for symptomatic relief of anxiety in pediatric patients 1
- Pruritus management: Effective for managing pruritus due to allergic conditions such as chronic urticaria and atopic dermatoses 1
- Premedication sedation: Can be used as a sedative for premedication before procedures 1
- Anxiolysis for medical imaging: Hydroxyzine is approved for anxiolytic use in both Europe and the United States for pediatric patients undergoing imaging procedures 2
Administration Considerations
- Hydroxyzine syrup formulation facilitates administration to children who may have difficulty swallowing tablets 3
- The medication can be administered orally even after initial treatment is initiated via intramuscular route 1
- Dosage should be adjusted according to the patient's response to therapy 1
Safety Considerations
- Hydroxyzine has been shown to be a safe oral sedative when used at proper dosages 4
- Most common adverse effects are drowsiness and dry mouth 4
- Respiratory complications may occur due to synergistic reactions when combined with other sedatives 4
- Monitor for potential sedative effects, especially when combined with other medications 4, 5
Special Populations
- Renal impairment: Reduce the dose by half in patients with renal impairment 3
- Severe renal impairment: Avoid use in patients with creatinine clearance <10 mL/min 3
- Hepatic impairment: Avoid use in patients with severe hepatic impairment due to increased sedating effects 3
Combination Therapy Considerations
- When combined with other sedatives like midazolam, no significant differences in physiological parameters have been observed compared to other sedative combinations 5, 6
- Hydroxyzine (1 mg/kg) has been safely used in combination with midazolam for pediatric dental procedures 5
Monitoring Recommendations
- Although hydroxyzine is generally safe, monitoring of vital signs is recommended when used for sedation purposes 4, 7
- No significant changes in heart rate, oxygen saturation, or respiratory rate have been observed with standard dosing 5
Remember that hydroxyzine dosing should be carefully calculated based on the child's weight and age, and the syrup formulation provides flexibility for accurate dosing in the pediatric population.