Atarax – composition, action, dosage, indications and contraindications

Proven content

Atarax is a prescription-only medicine. The active substance in Atarax is hydroxyzine, which has a sedative, anxiolytic and antihistamine effect. Atarax is primarily used to combat anxiety in adults. What are the contraindications to the use of this preparation? How to properly and safely dose it? Can the use of Atarax cause a side effect in a patient? How much does Atarax cost?

What are the causes of excessive anxiety?

Stressful situations are the most common causes of anxiety. They are understandable and legitimate. However, when anxiety becomes an obsession or when the feeling of anxiety constantly accompanies us, hinders sleep and social contacts, and even causes diseases (diseases of the nervous system, heart, digestive system), then we are dealing with a disorder.

The reasons for such a disorder are due to:

1. personality type (perfectionism, low self-esteem, need for control);
2. family history of mental disorders;
3. physical health problems (diabetes, asthma, heart disease, hormonal disorders);
4. taking psychoactive substances (even sedatives, when taken in excess, exacerbate anxiety).

What should you know about anxiety and anxiety? Check: anxiety

How to cure anxiety?

One of the ways of treating anxiety disorders is psychological therapy, the other – pharmacological treatment (often both treatments are used together).

It is also worth trying to control the states of anxiety yourself. This can be done by:

1. healthy lifestyle (healthy eating, physical activity, sleep);
2. solving conflicts at their beginning, thanks to open communication of one’s needs and expectations;
3. rest and relaxation;
4. withdrawal from alcohol, restriction of stimulants.

What anti-anxiety medications are available on the market and which are worth reaching for? Check: Anti-anxiety drugs – types, action, natural preparations. How are anxiety disorders treated?

Atarax – general characteristics of the drug

Atarax to lek o has a sedative, anxiolytic, hypnotic and antihistamine effect. The active substance is hydroxyzine. It shows an action:

1. calming;
2. sleeping pills;
3. antiemetic;
4. antihistamines;
5. mild pain reliever.

Atarax is available in the form of film-coated tablets, as well as a syrup.

Coated tablets may contain 10 mg or 25 mg of the active ingredient, i.e. hydroxyzine. The 10 mg film-coated tablets are white and round, while the 25 mg tablets are white and oblong with a line separating the tablet in half.

Atarax syrup 2 mg / ml is a clear, colorless solution. The pack contains an amber glass bottle with a child-resistant closable plastic screw cap containing 200 ml of syrup and a 0,25 ml graduated oral dosing syringe.

The entity responsible for the production and distribution of Atarax is UCB Pharma SA. UCB Pharma Sp. z o. o. has been present on the market since 1928. The seat of the company is invariably in Brussels, and for over 30 years the company has been operating in Poland, with an office located in Warsaw and medical representatives in all regions of Poland. The company is an international and biopharmaceutical company that is present in the markets of around 40 countries around the world, focusing its activities on serious diseases.

Can anxiety affect our gait? Check: Anxiety affects the way we walk. Pay attention to this detail

Atarax – composition and action of the drug

The main component of Atarax is responsible for its healing properties hydroxyzine. One tablet of Atarax contains 10 or 25 mg of hydroxyzine. In the case of syrup, 2 mg of this active substance corresponds to one ml of the drug.

Hydroxyzine is a derivative of piperazine and primarily has a sedative, anxiolytic and hypnotic effect. The mechanism of action of this substance is probably related to the inhibition of the activity of centers in the subcortical layer of the central nervous system.

Importantly, hydroxyzine does not inhibit the activity of the cerebral cortex. This compound, on the other hand, reduces the state of internal tension, anxiety, anxiety and muscle tension. It also has antihistamine, cholinolytic, analgesic and antiemetic properties.

At therapeutic doses, it does not increase the secretion or acidity of gastric acid and in most cases has a mild antisecretory effect.

Hydroxyzine is rapidly absorbed from the gastrointestinal tract. The antihistaminic effect begins approximately one hour after administration of the drug, while the sedative effect begins 5-10 minutes after administration in the form of a syrup and 30-45 minutes after administration of the drug in the form of tablets. The drug works for 6-8 hours. Hydroxyzine is extensively metabolized. Alcohol dehydrogenase is involved in the formation of the main metabolite – cetirizine. The metabolites of hydroxyzine are excreted by the kidneys, only 0,8% of the administered dose is excreted unchanged.

The other ingredients of the drug depend on the form of the drug and the dose of the active substance:

1. 10 mg film-coated tablets: lactose monohydrate, maize starch, talc, calcium stearate, povidone K 30. Coating composition: eudragit E 12,5% ​​solution, macrogol 6000, titanium dioxide (E171), talc;
2. 25 mg film-coated tablets: lactose monohydrate, microcrystalline cellulose, magnesium stearate, colloidal anhydrous silica. Coating composition: Opadry Y-1-7000 (titanium dioxide, hypromellose, macrogol 400);
3. syrup: ethanol, sodium benzoate, sucrose, menthol, nut flavor, purified water.

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Atarax – indications for the use of the drug

Atarax is primarily a sedative, anxiolytic and hypnotic drug. Therefore, it is recommended to take it in states of anxiety and anxiety, and sometimes also psychomotor agitation. However, it is also a drug that can be used in cases of:

1. persistent itching associated with eczema, hives and dermatitis;
2. before surgery to reduce the fear of surgery.

What are anxiety disorders and how to fight them? Check: Anxiety disorders – causes, symptoms. Are anxiety disorders curable?

Atarax – contraindications to the use of the drug

The drug Atarax, despite its effectiveness in the treatment of anxiety disorders, cannot be used by every patient struggling with this type of ailments.

Contraindications to the use of Atarax are:

1. allergy to the active substance or any of the other ingredients of the drug;
2. allergy to cetirizine, other piperazine derivatives, aminophylline or ethylenediamine;
3. porphyria;
4. abnormalities of the heart rhythm called “QT prolongation” as shown by ECG;
5. cardiovascular disease or if the heart rate is very low;
6. low electrolytes – such as low levels of potassium or magnesium;
7. certain drugs to treat abnormal heart rhythms or drugs that can affect the rhythm of the heart;
8. sudden death due to heart disease in a close family of the patient;
9. pregnancy and breastfeeding.

How does trauma affect the mental and physical condition of a person? Check: Trauma – its impact on mental and physical health

Atarax – precautions

Before and during the use of Atarax, follow the precautions included in the package leaflet.

Precautions should be taken especially in the case of:

1. if you have an increased risk of seizures – in children, the occurrence of seizures has been reported more frequently than in adults;
2. if you have glaucoma;
3. if you have a problem with the drainage of urine from the bladder;
4. if you suffer from decreased gastrointestinal motility;
5. if you suffer from myasthenia gravis – weakness and fatigue in the skeletal muscles after repeated exercise; the first symptoms are drooping eyelids, double vision, nasal voice, difficulty in chewing and swallowing, difficulty lifting the arms, walking or dullness;
6. if Atarax is used concomitantly with other drugs that depress the central nervous system or drugs with anticholinergic properties.

Taking Atarax may be associated with an increased risk of arrhythmias which may be life-threatening. Therefore, tell your doctor about any heart problems you have and if you are taking any other medications, including over-the-counter medications.

If you experience heart symptoms such as a rapid heartbeat (palpitations), breathing problems or loss of consciousness while taking Atarax, see your doctor immediately. Treatment with hydroxyzine should also be discontinued.

Treatment with Atarax should also be stopped at least 5 days before allergy testing is performed.

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Atarax – dosage and method of use

Atarax is a prescription drug. It should be taken in the lowest effective dose and for the shortest possible time. In adults and children weighing more than 40 kg, the maximum daily dose is 100 mg. The usual doses of Atarax are listed below.

Dosage of Atarax in accordance with the package leaflet:

1. symptomatic treatment of anxiety – 50 mg daily in 2-3 doses, in severe cases up to 100 mg daily;
2. symptomatic treatment of pruritus – initially 25 mg at bedtime, then 25 mg in 3-4 doses;
3. before surgery 100 mg in one or two doses.

Lower doses are used in children. In children and adolescents weighing up to 40 kg, the maximum daily dose is 2 mg / kg body weight daily. In children and adolescents weighing more than 40 kg, the maximum daily dose is 100 mg:

1. symptomatic treatment of pruritus – 1 mg / kg body weight daily to 2 mg / kg body weight daily in divided doses;
2. before surgery – 0,6 mg / kg body weight orally in a single dose. The cumulative daily dose should not exceed 2 mg / kg body weight per day. 

The use of Atarax and hydroxyzine in general in the elderly is not indicated. If a treatment decision is made, it is recommended to start treatment with half the recommended dose. In the elderly, the maximum daily dose is 50 mg.

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Atarax – possible side effects

Atarax, like any other drug, may cause side effects in patients. It is important to report any suspected adverse reactions after authorization of the medicinal product so that the benefit / risk balance of the medicinal product can be monitored.

The frequency classification of adverse body reactions (ADRs) is based on the following principles: very common (≥1 / 10), common (≥1 / 100 to <1/10), uncommon (≥1 / 1 to <000/1), rare (≥ 100 / 1 to <10 / 000), very rare (<1 / 1), not known (cannot be estimated from the available data).

Very common side effects after taking Atarax:

1. somnolence.

Common side effects after taking Atarax:

1. dry mouth;
2. tiredness;
3. Headache;
4. sedation (sedation).

Uncommon side effects after taking Atarax:

1. nausea;
2. bad mood;
3. fever;
4. dizziness;
5. insomnia;
6. trembling;
7. stimulation;
8. entanglement.

Rare side effects after taking Atarax:

1. tachycardia – increased heart rate;
2. accommodation disorders;
3. blurred vision;
4. constipation;
5. vomiting;
6. hypersensitivity reactions;
7. abnormal liver function tests;
8. seizures;
9. dyskinesia – independent, uncoordinated movements of the limbs and other parts of the body;
10. confusion;
11. hallucinations;
12. urinary retention;
13. itching;
14. erythematous rash;
15. maculopapular rash;
16. hives;
17. skin infection;
18. arterial hypotension.

Very rare side effects after taking Atarax:

1. anaphylactic shock, is caused by a severe systemic allergic reaction, its symptoms are: shortness of breath, swelling of the larynx and throat, itching and redness of the skin, headache, feeling of “tightness”, dizziness, severe weakness, including loss of consciousness, in severe cases can be life threatening;
2. bronchospasm;
3. angioedema – skin eruptions in the form of irregular spots, blisters and swelling;
4. increased sweating;
5. permanent drug rash;
6. acute generalized pustular eruption – a pustular rash on reddened skin, which may be associated with swelling and general symptoms such as fever;
7. erythema multiforme – a skin rash that may blister and look like small targets – a dark spot surrounded by a lighter area and a dark circle around it;
8. Stevens-Johnson syndrome – a widespread rash with blisters and peeling skin, mainly around the mouth, eyes, nose and genitals.

Side effects after taking Atarax, the frequency of which is not known:

1. prolongation of the QT interval on the electrocardiogram;
2. torsade de pointes heart rhythm disturbances;
3. hepatitis;
4. loss of consciousness (fainting);
5. bullous lesions – e.g. toxic epidermal necrolysis;
6. pemphigoid – an autoimmune skin disease characterized by well-tightened blisters located within erythematous-edema eruptions and in apparently unchanged skin.

In addition, the following side effects related to cetirizine, the main metabolite of hydroxyzine, which can also occur after administration of Atarax, have been reported: decreased platelet count, aggressiveness, depression, tics, involuntary movements, pins and needles, forced gazing with eye rotation, diarrhea, difficulty in urination, involuntary urination, asthenia (tiredness, weakness), swelling as well as weight gain.

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Atarax – interactions with other drugs

Before starting treatment with Atarax, please inform your doctor or pharmacist about all the medicines you are taking or have taken recently. You should also inform what medications the patient plans to take in the near future.

Atarax may influence the way other medicines work, but other medicines may also influence the way Atarax works.

This mainly applies to the following drugs:

1. depressants of the central nervous system or drugs with anticholinergic activity;
2. betahistine and cholinesterase inhibitors;
3. monoamine oxidase inhibitors – drugs used, among others depressed;
4. adrenaline;
5. medicines that can cause heart rhythm problems.

Also, remember not to take Atarax if you are taking medicines used to treat:

1. bacterial infections – e.g. antibiotics such as erythromycin, moxifloxacin, levofloxacin;
2. fungal infections – e.g. pentamidine;
3. heart disease or high blood pressure – e.g. amiodarone, quinidine, disopyramide, sotalol
4. psychoz — np. haloperydol;
5. depression – e.g. citalopram, escitalopram;
6. gastrointestinal diseases – e.g. prucalopride;
7. allergies;
8. malaria – e.g. mefloquine, hydroxychloroquine;
9. lock — n.p. toremifen, vandetanib;
10. drug addiction or severe pain – methadone.

Which drugs should never be combined with each other? Check: Dangerous interactions

Atarax and pregnancy and breastfeeding

The use of any medications or dietary supplements during pregnancy requires consultation with the attending physician. If you are pregnant or breastfeeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking Atarax.

Atarax must not be used during pregnancy. Therefore, women of childbearing potential must use an appropriate method of contraception to prevent pregnancy during treatment with hydroxyzine.

Atarax cannot be used during breastfeeding. Breast-feeding should be discontinued if treatment with Atarax is necessary.

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Atarax – prepare dinner

Dinner at Atarax may differ depending on the city in which the preparation will be purchased or the pharmacy chosen by the patient. The price of the product also depends on the selected form of the drug and the content of the active substance:

1. 25 10 mg coated tablets cost about PLN 13;
2. 25 25 mg coated tablets cost about PLN 15;
3. 200 m of 2mg / ml syrup costs about 19 zlotys.

How much money does the average Pole spend on treatment? Check: The Pole is not expected to see a doctor

Atarax – replacements

Products that have the same international name and exist in the same form do not have to be substitutes, because the use of a given drug is determined by the content of the active substance, i.e. the dose of the drug.

It should be remembered that even when the dose of the active substance is similar, the patient may not always use the substitute, because he may be allergic to any of the other excipients of the drug.

Therefore, before using a substitute for Atarax, read the package leaflet or consult your doctor or pharmacist.

The preparations containing the same ingredient as Atarax and showing similar properties include:

1. Hydroxyzine Orion – coated tablets;
2. Hydroxyzinum Adamed – coated tablets;
3. Hydroxyzinum Aflofarm – syrup;
4. Hydroxyzinum Espefa — syrop;
5. Hydroxyzinum Espefa – coated tablets;
6. Hydroxyzinum Hasco — syrop;
7. Hydroxyzinum Hasco – coated tablets;
8. Hydroxyzinum Polfarmex – syrup;
9. Hydroxyzinum Polfarmex – coated tablets;
10. Hydroxyzinum Teva – solution for injection;
11. Hydroxyzinum VP — syrop;
12. Hydroxyzinum VP – coated tablets;
13. Hydroxyzinum Zentiva – coated tablets.

When is it worth asking the pharmacy about drug substitutes? Check: Swap when you can

Atarax – reviews

The drug can be used temporarily, in times of anxiety or in the treatment of neuroses. Patient reviews are positive about the sedative effect. The only drawback is drowsiness, although this symptom occurs only in some patients. In the case of increased sleepiness, it may interfere with daily activities. Do not drive while using the product.