Hydroxyzine is an antihistamine medication with various uses and effects. People taking hydroxyzine can be at risk of overdose, particularly when using more than is prescribed, without a prescription, or alongside other substances. In the event of a hydroxyzine overdose, medical care may be required to manage serious symptoms.
- Hydroxyzine is an antihistamine that is only available by prescription.
- Signs of hydroxyzine overdose include oversedation, seizures, heart palpitations, and confusion.
- There is no antidote for hydroxyzine overdose, although medical treatment can be provided to manage symptoms and improve outcomes.
Can you overdose on hydroxyzine?
It is possible to overdose on hydroxyzine. Taking larger or more frequent doses of hydroxyzine than prescribed or recommended can result in overdose. Additionally, overdose may be more likely if it is used alongside certain other medications or substances. [2][3]
Hydroxyzine is an antihistamine medication used to treat anxiety and tension, itching caused by allergic reactions, and as a sedative before and after surgery. It is also sometimes used to treat nausea and sleeping problems. Hydroxyzine is available on prescription and can be taken as a regular medication or on an as-needed basis. [1]
Maximum recommended dosage for hydroxyzine
Maximum recommended doses of hydroxyzine for adults are: [3]
- 400 mg per day for anxiety and tension
- 100 mg per day for pruritus
- 100 mg in a single dose when used for sedation
The maximum recommended dose of hydroxyzine for children over the age of 6 is 100 mg per day, in divided doses. For children under the age of 6, the maximum recommended daily dose is 50 mg. When used for sedation, the maximum hydroxyzine dose is 0.6 mg per kg of body weight. [3]
Can a hydroxyzine overdose cause death?
An overdose of hydroxyzine is unlikely to be fatal in most cases, particularly if medical treatment is utilized quickly and symptoms are effectively managed. [2]
However, underlying health issues, concurrent substance use, or very large doses of hydroxyzine might contribute to more severe outcomes of hydroxyzine overdose and, in some cases, may be fatal. Taking other substances with hydroxyzine can increase the risk of fatality. [1][4]
Hydroxyzine can affect the heart and, in overdose, can cause dangerous cardiac effects. As such, people with a history of heart issues may be at increased risk of death from hydroxyzine overdose. [3][4]
Symptoms of hydroxyzine overdose
Symptoms of a hydroxyzine overdose can range from mild to severe and might depend on several factors. Symptoms can include: [2][3]
- Oversedation and excessive drowsiness
- Dizziness
- Convulsions
- Shaking
- Nausea and vomiting
- Shortness of breath
- Increased heart rate and blood pressure
- Blurred vision
- Dry mouth
- Heart palpitations
- Dilated pupils
- Agitation
- Low mood
- Nervousness
- Loss of consciousness
- Uncoordinated movements
- Hallucinations
- Redness or flushing
- Confusion
Risk factors and special considerations
People taking hydroxyzine should be aware of the following risk factors and special considerations: [1][2][3]
- Hydroxyzine can interact with other substances, causing enhanced central nervous system (CNS) depression. For example, benzodiazepines, opioids, and alcohol can interact with hydroxyzine and cause oversedation and increased risk of overdose.
- Hydroxyzine use can result in cardiac issues related to QT interval length. Because of this, people with a history of heart conditions may be at risk of cardiac-related effects with prescribed use, misuse, or overdose. Additionally, other QT-prolonging medications can increase this risk.
- Children and older adults often metabolize drugs at a different rate than adults. Because of this, smaller doses are typically required for these age groups, as overdose can be more likely to occur.
- People who misuse or are addicted to other medications or substances can be at increased risk of overdose, as concurrent substance use can cause interactions or impact the effects of each substance. Medications used in substance use disorder treatment might also interact with hydroxyzine, so this should be considered before commencing a new treatment.
Prevention of hydroxyzine overdose
If hydroxyzine is taken exactly as prescribed, it is unlikely to cause overdose. People who misuse hydroxyzine or use it when it is not prescribed to them may be at risk of overdose.
Before commencing hydroxyzine treatment, it is important to discuss any medications, substances, or supplements being used or any health conditions with the prescribing doctor. The doctor can ensure that the medication is prescribed appropriately and dose adjustments are made as required, to help prevent adverse effects and reduce the risk of overdose.
Immediate steps to take in case of overdose
If a hydroxyzine overdose is suspected, contact a medical professional, as treatment may be necessary. Poison Control can offer advice to manage an overdose by calling 1-800-222-1222. In an emergency, such as trouble breathing, seizures, or loss of consciousness, call 911 immediately. [1]
If possible, the individual should attempt to induce vomiting to remove the medication from the body. [3]
It might be necessary to go to the hospital for urgent care. It can be helpful to have the following information available to help the doctors: [2]
- The age, weight, and current condition of the individual
- The name and amount of medication taken, and at what time
- Whether it is prescribed
- Any other medications or conditions
Medical treatment for hydroxyzine overdose
There is no specific medication for a hydroxyzine overdose. However, various treatments can be implemented to reduce the severity of overdose effects, which may need to be provided in a hospital. [3]
- Gastric lavage (stomach pumping) may be necessary to remove the substance from the body in certain circumstances, and activated charcoal may also be used to help reduce toxic levels. [2]
- Professional monitoring and supportive care can help ensure the individual’s safety and well-being. Vital signs will be regularly checked and symptoms managed. For example, hypotension can be managed with medications, and breathing issues can be managed with a ventilator if necessary. [1]
If additional substances have been taken concurrently, there may be other treatments required.
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