From the Guidelines
Atarax, containing hydroxyzine, is contraindicated in early pregnancy, particularly during the first trimester, as stated in its U.K. manufacturer’s Summary of Product Characteristics 1.
Key Contraindications
- Pregnancy: Hydroxyzine is specifically contraindicated during the early stages of pregnancy 1
- Hypersensitivity: Patients with known hypersensitivity to hydroxyzine or other piperazine derivatives should avoid Atarax
- Nursing mothers: Atarax is contraindicated in nursing mothers due to the potential risk of adverse effects on the infant Additionally, caution is recommended when considering the use of Atarax in patients with certain medical conditions, although specific contraindications may vary depending on the individual case.
From the FDA Drug Label
Oral hydroxyzine hydrochloride is contraindicated in patients with known hypersensitivity to hydroxyzine hydrochloride products, and in patients with known hypersensitivity to cetirizine hydrochloride or levocetirizine hydrochloride. Hydroxyzine is contraindicated in patients with a prolonged QT interval. ... Hydroxyzine is contraindicated in early pregnancy. Hydroxyzine is contraindicated for patients who have shown a previous hypersensitivity to any component of this medication.
The contraindications of Atarax (hydroxyzine) are:
- Known hypersensitivity to hydroxyzine hydrochloride products
- Known hypersensitivity to cetirizine hydrochloride or levocetirizine hydrochloride
- Prolonged QT interval
- Early pregnancy
- Previous hypersensitivity to any component of this medication 2
From the Research
Contraindications of Atarax (Hydroxyzine)
The contraindications of Atarax (hydroxyzine) are as follows:
- Known hypersensitivity to hydroxyzine or any component of the formulation 3
- Pregnancy, although studies suggest that hydroxyzine does not appear to be associated with increased teratogenic risk 3, 4
- Patients with a history of QT prolongation or torsade de pointes, as hydroxyzine can inhibit human ether-a-go-go-related gene (HERG) current and cause syncope in patients with the HERG mutation 5, 6
- Patients with underlying medical conditions or concomitant medications that constitute a risk factor for QT prolongation and/or torsade de pointes 5
- Patients with cardiovascular disorders, as the combination of cardiovascular disorders plus concomitant treatment of drugs known to induce arrhythmia was identified as the greatest combined risk factor for QT prolongation and/or torsade de pointes 5
Special Precautions
Special precautions should be taken when using hydroxyzine in certain patient populations, including:
- Patients with a history of arrhythmias or cardiac conduction disorders
- Patients with a family history of QT prolongation or torsade de pointes
- Patients taking other medications that can prolong the QT interval or induce torsade de pointes
- Pregnant or breastfeeding women, although the risk of teratogenicity appears to be low 3, 4