What is the recommended dose of Hydroxyzine (Atarax)?

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From the Guidelines

Hydroxyzine should be dosed at 10-50 mg, particularly when used as a sedating antihistamine at night, as evidenced by the British Journal of Dermatology guidelines 1. When considering the use of hydroxyzine, it's essential to weigh the potential benefits against the risks, especially in patients with certain medical conditions.

  • The medication can be effective for treating urticaria, especially when combined with a non-sedating antihistamine during the day.
  • However, it's crucial to be aware of the potential side effects, such as sedation, dry mouth, and blurred vision, as noted in the guidelines 1.
  • In patients with renal impairment, caution should be exercised, and alternative treatments may be necessary, as certain antihistamines like acrivastine should be avoided in moderate renal impairment 1.
  • The dosage may need to be adjusted based on individual patient response and tolerance, as well as factors like age and hepatic function.
  • It's also important to consider the potential for QT interval prolongation and use the medication cautiously in patients with cardiovascular disease, as mentioned in the context of other antihistamines like mizolastine 1.

From the FDA Drug Label

For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested: adults, 50 to 100 mg 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. 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. As a sedative when used as a premedication and following general anesthesia: 50 to 100 mg for adults and 0. 6 mg/kg of body weight in children.

The recommended dose of hydroxyzine varies by indication and age:

  • Anxiety and tension:
    • Adults: 50 to 100 mg 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
  • Pruritus due to allergic conditions:
    • 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
  • Sedative:
    • Adults: 50 to 100 mg
    • Children: 0.6 mg/kg of body weight 2

From the Research

Hydroxyzine Dosage Information

  • The provided studies do not explicitly mention the dosage of hydroxyzine used in the treatment of generalized anxiety disorder (GAD) or other conditions 3, 4.
  • However, the studies discuss the efficacy and tolerability of hydroxyzine in comparison to other anxiolytic agents and placebo 3.
  • In the study published in 2010, hydroxyzine was found to be more effective than placebo for GAD, but the dosage used was not specified 3.
  • The 1975 study compared the effectiveness of hydroxyzine to other antihistamines in suppressing histamine-induced pruritus, but again, the dosage was not mentioned 4.
  • The side effects of hydroxyzine, such as drowsiness, were reported in both studies, but the dosage at which these side effects occurred was not provided 3, 4.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Hydroxyzine for generalised anxiety disorder.

The Cochrane database of systematic reviews, 2010

Research

Suppression of histamine-induced pruritus by three antihistaminic drugs.

The Journal of allergy and clinical immunology, 1975

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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