Hydroxyzine Treatment Guidelines

Dosing and Administration

For urticaria, hydroxyzine can be added at night (10-50 mg) to a non-sedating antihistamine taken during the day, according to the British Journal of Dermatology 1
Adjust timing so highest drug levels occur when symptoms are anticipated, as recommended by the British Journal of Dermatology 1

Hydroxyzine is specifically contraindicated during early pregnancy, as stated by the British Journal of Dermatology 1
If antihistamine therapy is absolutely necessary during pregnancy, chlorphenamine is preferred due to its longer safety record, according to the British Journal of Dermatology 1
Patients with moderate renal impairment (creatinine clearance 10-20 mL/min) require dose reduction to half the standard dose, as recommended by the British Journal of Dermatology 1
Hydroxyzine should be avoided entirely in severe renal impairment (creatinine clearance <10 mL/min), according to the British Journal of Dermatology 1
Hydroxyzine should be avoided in severe liver disease due to inappropriate sedating effects, as stated by the British Journal of Dermatology 1

Start elderly patients on low doses and monitor closely for confusion, over-sedation, and fall risk, as recommended by the British Journal of Dermatology 1
Elderly patients have increased sensitivity to psychomotor impairment, according to the British Journal of Dermatology 1