Atarax
Atarax (Hydroxyzine 10/25 mg) — sedating first-generation antihistamine for PRN anxiety, pruritus, sedation, antiemetic. non-addictive PRN anxiolytic — onset 30–60 min.
✓ Medisinsk vurdert av Morgan Ellis — Farmasøytisk forsker · 8 års erfaring · Sist gjennomgått: mai 2026
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Atarax (Hydroxyzine 10 / 25 mg) is a sedating first-generation antihistamine and centrally-acting anxiolytic. Used for short-term anxiety, pre-procedural sedation, allergic pruritus and urticaria, and as an antiemetic. Non-addictive — useful when benzodiazepines are inappropriate.
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What Atarax is and how it works
Atarax is a 10 / 25 mg hydroxyzine tablet supplied by UCB. Hydroxyzine is a piperazine first-generation antihistamine with strong central H1 antagonism, weak 5-HT2A antagonism, and modest anticholinergic activity. The H1 component crosses the blood-brain barrier well and is the basis for its sedating and anxiolytic effect.
Hydroxyzine is one of the few non-benzodiazepine, non-barbiturate options for true PRN anxiety relief — onset within 30–60 minutes, duration 4–6 hours.
Indikasjoner og dosering
| Indikasjon | Voksendose | Merknader |
|---|---|---|
| Acute anxiety / agitation | 25–100 mg PO/IM, may repeat q6h | Max 400 mg/day |
| Pruritus / urticaria | 25 mg TID–QID | Max 100 mg QID |
| Pre-operative sedation | 50–100 mg 1 hour pre-op | — |
| Antiemetic | 25–100 mg IM | Adults only |
| Insomnia (off-label) | 25–50 mg HS | Short-term only |
| Paediatric pruritus / sedation | 0.5–1 mg/kg/dose q6h | — |
| Older adults (any indication) | start 10–25 mg | QT and falls risk |
Viktige sikkerhetshensyn
Hydroxyzine prolongs QT in a dose-dependent manner. The EMA restricted dosing in 2015: maximum 100 mg/day in adults, 50 mg/day in older adults, and 2 mg/kg/day in children. Avoid in known QT prolongation, hypokalaemia/hypomagnesaemia, recent MI, uncompensated heart failure, and concurrent QT-prolonging drugs (azoles, macrolides, fluoroquinolones, methadone, ondansetron, antipsychotics). Pre-treatment ECG advised in older adults.
Hydroxyzine has meaningful anticholinergic activity — particularly relevant in older adults (Beers Criteria potentially inappropriate medication). Avoid in narrow-angle glaucoma, BPH with retention, dementia, severe constipation. The American Geriatrics Society discourages first-generation antihistamines as PRN agents in older adults.
Single-dose sedation can persist 6+ hours; avoid driving and operating machinery until tolerability is known. Particularly problematic in opioid-naive surgical patients on the day of discharge.
Vanlige bivirkninger
- Sedation / drowsiness: universal at therapeutic doses.
- Anticholinergic: dry mouth, constipation, urinary hesitancy, blurred vision.
- QT: dose-dependent prolongation.
- CNS: dizziness, ataxia, paradoxical agitation in older adults and children.
- Withdrawal: none — non-addictive.
Legemiddelinteraksjoner
- Andre QT-forlengende legemidler — additive risk.
- CNS depressants (alcohol, benzodiazepines, opioids, Z-drugs) — additive sedation.
- Anticholinergics — additive burden.
- MAOIs — additive anticholinergic and CNS depressant effects.
Graviditet, amming, pediatri
Pregnancy: avoid in early pregnancy; safer alternatives exist. Breastfeeding: passes into milk and can sedate the infant; usually avoided. Paediatric: dosing per kg, watch for paradoxical excitation (5–10% of children).
Oppbevaring
Oppbevar ved 15–30 °C i originalemballasje.
Vanlige spørsmål
How is Atarax different from a benzodiazepine?
Hydroxyzine acts on H1 histamine receptors, not GABA-A. The clinical translation: similar acute sedation, similar anxiolysis, but no abuse potential, no dependence, no respiratory depression with overdose, no withdrawal syndrome. Hydroxyzine has a lower ceiling effect — at therapeutic doses it doesn’t reach the depth of acute relief produced by alprazolam or lorazepam.
Can I take Atarax as needed for anxiety?
Yes — onset is 30–60 minutes, duration 4–6 hours, and no addiction risk. Atarax is one of the better PRN options when benzodiazepines are inappropriate (substance-use history, pregnancy, occupational exposure to controlled-substance testing, primary-care setting reluctant to prescribe BZDs).
Will Atarax make me drowsy the next day?
Sometimes — particularly with bedtime doses 50 mg+. Older adults are most susceptible. Lower doses (25 mg) usually clear by morning.
Is Atarax safe in older adults?
Hydroxyzine is on the Beers Criteria list of potentially inappropriate medications in older adults because of anticholinergic burden, fall risk, and QT signal. Use is not absolutely prohibited but should be cautious, time-limited, and at lower doses.
Why does Atarax have a QT warning?
Like many sedating antihistamines, hydroxyzine prolongs the QT interval in a dose-dependent way. At occasional doses in young patients with normal ECGs the risk is negligible; at high daily doses or in older patients with cardiovascular disease the risk is clinically meaningful. The EMA dose caps reflect this.
Can Atarax be used long-term?
Daily use beyond a few weeks is uncommon — tolerance to the sedative effect develops, and the anticholinergic burden accumulates. For chronic GAD, an SSRI/SNRI or buspirone is preferred. Atarax works best as PRN or short-term bridge.
Can I drive on Atarax?
Avoid driving for at least 6–8 hours after a dose, particularly with the first few doses. Most patients on stable low-dose regimens drive normally — but the legal definition of impairment varies by jurisdiction.
Can Atarax be used in pregnancy?
First-trimester use is generally avoided because of theoretical concerns; later in pregnancy, hydroxyzine has been used for nausea-vomiting and pruritus with reasonable safety. Discuss with your obstetrician.
Can children take Atarax?
Yes — hydroxyzine is one of the older agents in paediatric sedation and pruritus. Watch for paradoxical excitation (5–10% of children become more agitated rather than less).
Is Atarax addictive?
No — no euphoria, no compulsive use, no withdrawal, no tolerance to anxiolytic effect (sedation tolerance does develop somewhat with daily use).
Andre psykofarmaka
- Busiron (Buspirone — non-sedating GAD)
- Lexaheal (Escitalopram — first-line GAD)
- Pexep (Paroxetine — first-line GAD)
- Mirtaz (Mirtazapine — sedating antidepressant)
- Fliban (Flibanserin — HSDD; female libido)
Flere alternativer innen psykisk helse og psykofarmaka
Rangert etter nylig bestillingsvolum på MedsBase — hva andre kunder i denne kategorien velger.
| Styrke | 10 mg, 25 mg |
|---|---|
| Antall | 30 tabletter, 60 tabletter, 90 tabletter, 180 tabletter |
Spørsmål og svar
Atarax
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