What is the recommended dose of hydroxyzine (an antihistamine) for a 5-year-old child with an allergic reaction?

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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. ; children under 6 years, 50 mg daily in divided doses; children over 6 years, 50 to 100 mg daily in divided doses.

The recommended dose of hydroxyzine for a 5-year-old child with an allergic reaction is 50 mg daily in divided doses 1.

From the Research

For a 5-year-old child with allergies, the recommended dose of hydroxyzine is 2 mg/kg/day divided into 3-4 doses, not exceeding 50 mg total per day for this age group, as this dosage is most likely to provide effective relief from allergy symptoms while minimizing potential side effects, as supported by the general principles of antihistamine use in children 2.

Key Considerations

  • Hydroxyzine is an antihistamine that works by blocking H1 receptors, reducing histamine effects that cause allergy symptoms like itching, hives, and swelling.
  • The medication can cause drowsiness, so the first dose is often best given at bedtime to assess how sedating it is for your child.
  • Side effects may include sedation, dry mouth, and occasionally paradoxical excitation in children.
  • If symptoms don't improve within 3-5 days or worsen at any point, contact your healthcare provider.

Dosage and Administration

  • The dose typically translates to about 10-12.5 mg per dose given three to four times daily.
  • It's crucial to use an appropriate measuring device for liquid formulations to ensure accurate dosing.
  • Always follow your doctor's specific instructions as they may adjust dosing based on your child's exact weight, severity of symptoms, and individual response to the medication, as antihistamine efficacy and safety can vary significantly in pediatric populations 3.

Evidence Basis

  • While specific studies on hydroxyzine dosing in children are limited, the principles of antihistamine use in pediatric populations guide the recommended dosage, emphasizing the importance of careful consideration of the child's weight, symptoms, and potential side effects 4, 2.

References

Research

Antihistamines: ABC for the pediatricians.

Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology, 2020

Research

Chronic Spontaneous Urticaria: Pathogenesis and Treatment Considerations.

Allergy, asthma & immunology research, 2017

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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