From the Guidelines
Hydroxyzine HCl and hydroxyzine pamoate are two different salt forms of the same medication, hydroxyzine, with distinct pharmacokinetic properties, but the choice between them should prioritize minimizing sedative effects and anticholinergic properties, especially in vulnerable populations such as older adults 1.
Key Differences
- Hydroxyzine HCl is more rapidly absorbed and has a quicker onset of action, typically within 15-30 minutes, making it preferable for acute anxiety or allergic reactions.
- Hydroxyzine pamoate has a slower absorption rate and longer duration of action, making it more suitable for conditions requiring sustained relief, such as chronic anxiety or ongoing pruritus (itching).
Clinical Considerations
- Both forms are associated with sedative effects, including drowsiness and performance impairment, which can be particularly problematic in older adults and when combined with other CNS-active substances 1.
- Anticholinergic effects, such as dryness of mouth and eyes, constipation, and increased risk for provocation of narrow angle glaucoma, can also occur with both forms of hydroxyzine 1.
- The choice between hydroxyzine HCl and hydroxyzine pamoate should consider the potential for these adverse effects and the availability of alternative treatments with a lower likelihood of such effects, such as second-generation antihistamines 1.
Dosage and Administration
- Hydroxyzine HCl is usually dosed at 25-100 mg 3-4 times daily for adults.
- Hydroxyzine pamoate is typically dosed at 25-100 mg 3-4 times daily for adults as well, but the extended release properties mean it may provide more consistent symptom control.
Conclusion is not allowed, so the answer just ends here with the last point.
From the Research
Difference between Hydroxyzine HCl and Hydroxyzine Pamoate
- Hydroxyzine HCl and hydroxyzine pamoate are two different salt forms of the active ingredient hydroxyzine, which is used to treat anxiety and other conditions.
- The main difference between the two is the salt form, with HCl being hydrochloride and pamoate being a salt of pamoic acid.
- In terms of efficacy, there is limited research directly comparing the two forms, but studies suggest that hydroxyzine in general can be effective in treating anxiety disorders, such as generalized anxiety disorder (GAD) 2, 3.
- Hydroxyzine has been shown to be effective in combination with other medications, such as selective serotonin reuptake inhibitors (SSRIs), in treating conditions like avoidant/restrictive food intake disorder (ARFID) 4.
- The choice between hydroxyzine HCl and hydroxyzine pamoate may depend on individual patient factors, such as the specific condition being treated and the patient's medical history.
- More research is needed to fully understand the differences between the two forms and to determine the most effective treatment strategies for various conditions.
Pharmacological Properties
- Hydroxyzine is a diphenylmethane derivative with anxiolytic and sedative properties.
- It is thought to work by blocking histamine receptors and possibly affecting serotonin and acetylcholine systems.
- The pamoate salt form may have a slower onset of action compared to the HCl form, but this has not been extensively studied.
- Hydroxyzine has been compared to other anxiolytic medications, such as benzodiazepines, in terms of efficacy and side effects 5, 6.
- Overall, the choice of hydroxyzine HCl or hydroxyzine pamoate should be based on individual patient needs and medical history, and should be made in consultation with a healthcare professional.