Can Hydroxyzine Tablets Be Crushed?
Yes, hydroxyzine tablets can generally be crushed and mixed with applesauce or other soft foods for patients with swallowing difficulties, as hydroxyzine is an immediate-release formulation without extended-release or enteric-coating properties that would be compromised by crushing.
Key Considerations for Crushing Hydroxyzine
Safety of Crushing Immediate-Release Formulations
Hydroxyzine is available as immediate-release tablets (not controlled-release or enteric-coated), which means crushing does not destroy any extended-release mechanism or protective coating 1, 2.
The primary concern with crushing tablets relates to medications with sustained-release properties or gastro-resistant layers—when these are crushed, it can result in dose dumping, overdose, or underdosing 1.
Since hydroxyzine lacks these special formulation characteristics, crushing does not alter its pharmacokinetics or create the same safety risks seen with extended-release medications 2.
Practical Administration Guidelines
Crushing method: Use appropriate crushing equipment and avoid cross-contamination between patients 3.
Vehicle selection: Mix crushed hydroxyzine with soft foods like applesauce, pudding, or jellified water for immediate administration 2, 3.
Timing: Administer the crushed medication immediately after preparation to prevent degradation 2.
Avoid questionable vehicles: While applesauce is appropriate, avoid mixing with acidic juices or foods that may affect drug stability 3.
Clinical Context for Hydroxyzine Use
Hydroxyzine is a sedating antihistamine commonly dosed at 10-50 mg at night for conditions like urticaria 4.
The medication should be avoided in severe liver disease due to its sedating effects, and doses should be halved in renal impairment 4.
Hydroxyzine is specifically contraindicated in early pregnancy 4.
Important Caveats
When Crushing Should Be Reconsidered
Always verify that the specific hydroxyzine formulation prescribed is immediate-release and not a specialized formulation 1, 2.
Consider alternatives such as liquid formulations if available, which eliminate the need for crushing 2.
Consult pharmacy if there is any uncertainty about whether the specific product can be safely crushed 5, 6.