Two different dr's have prescribed Hydroxyzine HCL for allergies and Hydroxyzine PAM for nausa with my pain meds. My regular dr doesn't believe they are different although they seem to react different in my body and my pharmacist agrees. Are they different?
The active ingredient, hydroxyzine, is the same in both formualtions, though the salt, pamoate or hydrochloride, to which it is attached is different. The pamoate comes as a capsule and the hydrochloride is a tablet. The release mechanism into the body is different between the two and hence why one may work better for you. Both the doctor and the pharmacist are correct. The doctor is looking at the active ingredient, hydroxyzine, which is what controls the symptoms of allergies and nausea, while he pharmacist is looking at the salt formulation which can affect how it is absorbed into your body.
Hydroxyzine is used for numerous unrelated medical conditions. I had been taking it for quite a while for allergies before finding out that it's commonly prescribed for anxiety! Sometimes it's even prescribed for sleep (though it doesn't personally make me drowsy). But the first commentor is correct. They're the same drug, just in different formulations.
I see this is an old question, however it is also the first Google hit after searching for this subject. The short answer is, yes. The long answer: for a long time they were thought to be interchangeable, but current tests and studies have been showing how different these are. HCL is just a simple salt, but Pamoic Acid is what you should research if you want to see the current information about the PAM form. You can follow the links from Pamoic Acid on wikipedia, all the way to HER2 if you wish, and follow up by doing the same on PubMed.
Officially, it is only a scientific fact that has not yet made it into clinical practice, but if it was my body, I'd stick with the HCL until more studies are completed and the receptor agonist and antinociceptive effects of PAM are clarified. When I took these two drugs, I didn't realize my pharmacist had switched them, and the drug stopped working for the purpose I needed. For me the antinociception was so strong, that it forced me into an awake and zombie state all night, instead of being usable as a sleep drug. It took me years to find two drugs that work for sleep, and if you will notice, the PAM also affects the 5-HT2A receptor. It basically has the opposite effect of seroquel and many other anti psychotic meds that can be used in small amounts for sleeplessness.
I am not a health care worker of any kind. But my inability to sleep for over 5 years has forced me to learn what these receptors do, and in my desperate search for sleep I found the HCL form of Hydroxizine works, and Seroquel at low doses works for me. I don't take them together, but when one stops working, I switch to the other so I don't take larger and larger doses of either. Your experience may be different from mine. As always, discuss this with your doctor, but I think you're free to choose one or the other of them as you wish at this time, until the effects of pamoic acid are better described.
- Hydroxyzine Information for Consumers
- Hydroxyzine Information for Healthcare Professionals (includes dosage details)
- Side Effects of Hydroxyzine (detailed)
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