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The following information outlines crucial safety warnings and contraindications for the use of hydroxyzine HCl (Atarax). It is important to read these details thoroughly and discuss any concerns with your healthcare provider.

• Drowsiness and Impaired Focus: Hydroxyzine HCl can cause significant drowsiness, which may impair your concentration, cognitive abilities, and reaction times. This effect is more pronounced in individuals aged 65 or older, those consuming alcohol, or those using other sedative medications such as opioids, benzodiazepines, and sleep aids. Until you understand how hydroxyzine HCl affects you, refrain from driving or operating heavy machinery.

• Heart Rhythm Disturbances (QT Prolongation): Although uncommon, there have been reports of heart rhythm irregularities, such as QT prolongation, in individuals taking hydroxyzine HCl. Those with pre-existing heart conditions or electrolyte imbalances may be at increased risk. Your healthcare provider may monitor your heart health more closely if you are also taking medications known to affect heart rhythm, such as certain antipsychotics or antibiotics. Seek immediate medical assistance if you experience symptoms like chest pounding, shortness of breath, chest pain, faintness, or lightheadedness.

• Increased Side Effects in Older Adults: Individuals aged 65 and older may experience more pronounced side effects when using antihistamines like hydroxyzine HCl. Your healthcare provider will likely start you on a lower dose and gradually increase it. Be alert for vision changes, severe dry mouth, difficulty urinating, constipation, and increased drowsiness, which can lead to falls and injuries. Discuss your risk factors with your healthcare provider before starting this medication.

• Severe Allergic and Skin Reactions: Some individuals may experience severe allergic reactions to hydroxyzine HCl, which can be life-threatening and include symptoms such as facial swelling, hives, and anaphylaxis. If you notice dizziness, a rapid heartbeat, choking sensation, difficulty breathing, or swelling around the eyes, lips, or tongue, seek emergency medical attention immediately. This risk is heightened if you have allergies to cetirizine (Zyrtec) or levocetirizine (Xyzal).

Contraindications: Do not use hydroxyzine HCl if you have:

• An allergy to cetirizine (Zyrtec) or levocetirizine (Xyzal).
• A heart rhythm condition known as prolonged QT interval or long QT syndrome.
• Are in the early stages of pregnancy.

For safe use of hydroxyzine HCl, ensure all potential risks and contraindications are discussed with your healthcare provider.

Common side effects:

• Drowsiness
• Dizziness
• Blurred vision
• Dry mouth
• Constipation

• Headache

  Less common but important to monitor:

• Mental or mood changes (anxiety, confusion, hallucinations)
• Shaking
• Trouble urinating

• Changes in vision

  Serious side effects:

• Seizures
• Fast or irregular heartbeat
• Severe dizziness
• Fainting
• Serious allergic reaction (rash, itching, swelling of the face, tongue, or throat, difficulty breathing)

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Opioid pain or cough relievers (such as codeine, hydrocodone)
• Alcohol
• Marijuana (cannabis)
• Drugs for sleep or anxiety (such as Alprazolam, Lorazepam, Zolpidem)
• Muscle relaxants (such as Carisoprodol, Cyclobenzaprine)
• Other antihistamines (such as diphenhydramine, Promethazine)