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Hydroxyzine pamoate (Vistaril) is associated with several important safety considerations. Please read the following warnings carefully and consult your healthcare provider if you have any questions or concerns:

• Drowsiness: This medication may cause significant drowsiness, impacting your concentration, thinking, and reflexes. This effect is heightened if you are 65 years or older, consume alcohol, or take other sedatives like opioids, benzodiazepines, or sleep aids. Avoid driving or operating heavy machinery until you understand how the medication affects you.

• Heart Rhythm Issues (QT Prolongation): Hydroxyzine pamoate may alter your heart rhythm, potentially leading to a serious condition known as QT prolongation. Your risk increases if you have low potassium or magnesium levels, existing heart issues, or are using other medications that affect heart rhythm, such as amiodarone or ciprofloxacin. Regular heart monitoring, such as EKGs, may be necessary. If you experience chest discomfort, breathlessness, or lightheadedness, seek emergency medical help immediately.

• Increased Side Effects in Older Adults: Individuals over 65 may experience heightened side effects, including vision changes, severe dry mouth, urinary difficulties, constipation, and increased drowsiness, potentially leading to falls. Discuss these risks with your healthcare provider before starting the medication.

• Severe Allergic and Skin Reactions: Some users may have severe allergic reactions, including facial swelling, hives, and anaphylaxis. Seek immediate medical help if you experience symptoms like dizziness, rapid heartbeat, breathing difficulties, or swelling of the face, lips, or tongue. This is particularly important if you have known allergies to cetirizine or levocetirizine.

Contraindications: This medication should not be used if you have the following conditions, as it may pose serious health risks:

• Allergy to cetirizine or levocetirizine.
• A heart rhythm condition known as prolonged QT interval or long QT syndrome.
• Early stages of pregnancy.

Always consult with your healthcare provider to determine if hydroxyzine pamoate is safe for you, especially if you have any of the conditions listed above.

When taking this medication, some individuals may experience mild side effects such as drowsiness, dizziness, blurred vision, constipation, dry mouth, or headache. These are generally not serious but should be discussed with a healthcare provider if they persist or worsen. For dry mouth, consider drinking water, chewing sugarless gum, or using a saliva substitute for relief.

There are also more serious side effects to be aware of, although they are rare. These include mental or mood changes like restlessness, confusion, or hallucinations, as well as shaking, difficulty urinating, and excessive sleepiness. In rare cases, an abnormal heart rhythm may occur, which can present as chest pain, irregular heartbeat, or difficulty breathing.

Additionally, serious allergic reactions, while uncommon, necessitate immediate medical attention. Symptoms might include rash, itching/swelling (especially of the face, tongue, or throat), hives, or trouble breathing. A serious skin reaction could involve fever, rash, or blisters. If you encounter any of these severe symptoms, seek medical help promptly. Always monitor for any other unusual effects and consult your healthcare provider for guidance.

When using hydroxyzine, it is crucial to inform your doctor or pharmacist if you are taking any other medications that may cause drowsiness. These include opioid pain relievers like codeine and hydrocodone, alcohol, marijuana, medications for sleep or anxiety such as alprazolam and lorazepam, muscle relaxants like carisoprodol and cyclobenzaprine, or other antihistamines such as diphenhydramine and promethazine. Always check the labels of over-the-counter medications, including allergy and cold remedies, as they might contain ingredients that can lead to drowsiness. Consult your pharmacist to ensure safe use of these products.

Avoid using hydroxyzine with other skin-applied antihistamines, as this could heighten side effects. Additionally, hydroxyzine is very similar to cetirizine and levocetirizine, so concurrent use is not advised. Be aware that hydroxyzine might interfere with certain lab tests, such as allergy skin tests and urine corticosteroid levels, potentially causing inaccurate results. Ensure all healthcare professionals involved in your care are informed that you are taking this medication.

Furthermore, hydroxyzine pamoate (Vistaril) can interact with a wide range of other medications. It is important to inform your healthcare providers about all drugs, supplements, and vitamins you are taking, whether they are prescription or over-the-counter. Certain medications should not be used alongside hydroxyzine, as severe interactions could occur. In some cases, your doctor might need to adjust the dosage if both medications are necessary. Always follow your healthcare provider's guidance closely when managing your medications.