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Vistaril Disease Interactions

There are 9 disease interactions with Vistaril (hydroxyzine).

Major

Anxiolytics/sedatives/hypnotics (applies to Vistaril) depression

Major Potential Hazard, Moderate plausibility.

A variety of abnormal thinking and behavior changes have been reported to occur in association with the use of most anxiolytics, sedatives and hypnotics. Some of these changes include decreased inhibition, aggressiveness, agitation, and hallucinations. These drugs can cause or exacerbate mental depression and cause suicidal behavior and ideation. Therapy with these drugs should be administered cautiously in patients with a history of depression or other psychiatric disorders. Patients should be monitored for any changes in mood or behavior. It may be prudent to refrain from dispensing large quantities of medication to these patients.

References

  1. (2002) "Product Information. Buspar (buspirone)." Bristol-Myers Squibb
  2. (2001) "Product Information. Ambien (zolpidem)." sanofi-aventis
  3. (2001) "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical
  4. (2001) "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc
  5. (2001) "Product Information. Equanil (meprobamate)." Wallace Laboratories
  6. (2001) "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories
  7. (2001) "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical
  8. (2002) "Product Information. Xyrem (sodium oxybate)." Orphan Medical
  9. (2004) "Product Information. Lunesta (eszopiclone)." Sepracor Inc
  10. (2005) "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America
  11. (2010) "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals
  12. (2013) "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group
  13. (2014) "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc
  14. (2014) "Product Information. Belsomra (suvorexant)." Merck & Co., Inc
View all 14 references
Major

Hydroxyzine (applies to Vistaril) QT prolongation

Major Potential Hazard, Moderate plausibility. Applicable conditions: Long QT Syndrome, Ventricular Arrhythmia, Myocardial Infarction, Heart Disease

Hydroxyzine is contraindicated in patients with a QT prolonged interval. Cases of QT prolongation and Torsade de Pointes have been reported during postmarketing studies. Most of the cases reported occurred in patients with other risk factors for QT prolongation, such as preexisting heart disease, electrolyte imbalances or arrhythmogenic drug use. Therefore, hydroxyzine should be used with caution in patients with risk factors for QT prolongation, congenital long QT syndrome, family history of long QT syndrome or other predisposing conditions, as well as myocardial infarction, uncompensated heart failure, and bradyarrhythmias.

References

  1. (2001) "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals
  2. (2001) "Product Information. Atarax (hydroxyzine)." Pfizer U.S. Pharmaceuticals
Moderate

Antihistamines (applies to Vistaril) anticholinergic effects

Moderate Potential Hazard, High plausibility. Applicable conditions: Gastrointestinal Obstruction, Glaucoma/Intraocular Hypertension, Urinary Retention

Antihistamines often have anticholinergic activity, to which elderly patients are particularly sensitive. Therapy with antihistamines should be administered cautiously, if at all, in patients with preexisting conditions that are likely to be exacerbated by anticholinergic activity, such as urinary retention or obstruction; angle-closure glaucoma, untreated intraocular hypertension, or uncontrolled primary open-angle glaucoma; and gastrointestinal obstructive disorders. Conventional, first-generation antihistamines such as the ethanolamines (bromodiphenhydramine, carbinoxamine, clemastine, dimenhydrinate, diphenhydramine, doxylamine, phenyltoloxamine) tend to exhibit substantial anticholinergic effects. In contrast, the newer, relatively nonsedating antihistamines (e.g., cetirizine, fexofenadine, loratadine) reportedly have low to minimal anticholinergic activity at normally recommended dosages and may be appropriate alternatives.

References

  1. Schuller DE, Turkewitz D (1986) "Adverse effects of antihistamines." Postgrad Med, 79, p. 75-86
  2. (2002) "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories
  3. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough
  4. (2002) "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc
  5. (2002) "Product Information. Benadryl (diphenhydramine)." Parke-Davis
  6. (2001) "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories
  7. (2001) "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation
  8. (2001) "Product Information. Antivert (meclizine)." Roerig Division
  9. (2001) "Product Information. Marezine (cyclizine)." Glaxo Wellcome
  10. (2001) "Product Information. Optimine (azatadine)." Schering Corporation
  11. (2001) "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC
  12. (2001) "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals
  13. (2001) "Product Information. Drixoral (dextromethorphan)." Schering-Plough
  14. (2001) "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company
  15. Watemberg NM, Roth KS, Alehan FK, Epstein CE (1999) "Central anticholinergic syndrome on therapeutic doses of cyproheptadine." Pediatrics, 103, p. 158-60
  16. (2001) "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals
  17. (2001) "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn
  18. (2001) "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation
  19. (2001) "Product Information. Temaril (trimeprazine)." Allergan Inc
  20. Talbert RL, Yee GC, DiPiro JT, Matzke GR, Posey LM, Wells BG (1999) "Pharmacotherapy: A Pathophysiologic Approach" Stamford, CT: Appleton & Lange
View all 20 references
Moderate

Antihistamines (applies to Vistaril) asthma/COPD

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Chronic Obstructive Pulmonary Disease

It has been suggested that the anticholinergic effect of antihistamines may reduce the volume and cause thickening of bronchial secretions, resulting in obstruction of respiratory tract. Some manufacturers and clinicians recommend that therapy with antihistamines be administered cautiously in patients with asthma or chronic obstructive pulmonary disease.

References

  1. (2002) "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories
  2. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough
  3. (2002) "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc
  4. (2002) "Product Information. Benadryl (diphenhydramine)." Parke-Davis
  5. (2001) "Product Information. Phenergan (promethazine)." Wyeth-Ayerst Laboratories
  6. Maddox DE, Reed CE (1987) "Clinical pharmacodynamics of antihistamines." Ann Allergy, 59, p. 43-8
  7. (2001) "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation
  8. (2001) "Product Information. Antivert (meclizine)." Roerig Division
  9. (2001) "Product Information. Marezine (cyclizine)." Glaxo Wellcome
  10. (2001) "Product Information. Optimine (azatadine)." Schering Corporation
  11. (2001) "Product Information. Semprex-D (acrivastine-pseudoephedrine)." Endo Laboratories LLC
  12. (2001) "Product Information. Drixoral (dextromethorphan)." Schering-Plough
  13. (2001) "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company
  14. (2001) "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals
  15. (2001) "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn
  16. (2001) "Product Information. Tacaryl (methdilazine)." Westwood Squibb Pharmaceutical Corporation
  17. (2001) "Product Information. Temaril (trimeprazine)." Allergan Inc
View all 17 references
Moderate

Antihistamines (applies to Vistaril) cardiovascular

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Cardiovascular Disease, Hyperthyroidism, Hypotension

Antihistamines may infrequently cause cardiovascular adverse effects related to their anticholinergic and local anesthetic (quinidine-like) activities. Tachycardia, palpitation, ECG changes, arrhythmias, hypotension, and hypertension have been reported. Although these effects are uncommon and usually limited to overdosage situations, the manufacturers and some clinicians recommend that therapy with antihistamines be administered cautiously in patients with cardiovascular disease, hypertension, and/or hyperthyroidism.

References

  1. Schuller DE, Turkewitz D (1986) "Adverse effects of antihistamines." Postgrad Med, 79, p. 75-86
  2. (2002) "Product Information. Dimetane (brompheniramine)." Wyeth-Ayerst Laboratories
  3. "Product Information. Chlor-Trimeton (chlorpheniramine)." Schering-Plough
  4. (2002) "Product Information. Periactin (cyproheptadine)." Merck & Co., Inc
  5. (2002) "Product Information. Benadryl (diphenhydramine)." Parke-Davis
  6. (2001) "Product Information. Tavist (clemastine)." Sandoz Pharmaceuticals Corporation
  7. (2001) "Product Information. Antivert (meclizine)." Roerig Division
  8. (2001) "Product Information. Optimine (azatadine)." Schering Corporation
  9. Smith SJ (1994) "Cardiovascular toxicity of antihistamines." Otolaryngol Head Neck Surg, 111 Suppl, p. 348-54
  10. (2001) "Product Information. Zyrtec (cetirizine)." Pfizer U.S. Pharmaceuticals
  11. Woosley RL (1996) "Cardiac actions of antihistamines." Annu Rev Pharmacol Toxicol, 36, p. 233-52
  12. (2001) "Product Information. Drixoral (dextromethorphan)." Schering-Plough
  13. (2001) "Product Information. Poly-Histine-D (pyrilamine)." Bock Pharmacal Company
  14. (2001) "Product Information. Vistaril (hydroxyzine)." Pfizer U.S. Pharmaceuticals
  15. (2001) "Product Information. Dramamine (dimenhydrinate)." Pharmacia and Upjohn
View all 15 references
Moderate

Antihistamines (applies to Vistaril) renal/liver disease

Moderate Potential Hazard, High plausibility. Applicable conditions: Renal Dysfunction

Limited pharmacokinetic data are available for the older, first-generation antihistamines. Many appear to be primarily metabolized by the liver, and both parent drugs and metabolites are excreted in the urine. Patients with renal and/or liver disease may be at greater risk for adverse effects from antihistamines due to drug and metabolite accumulation. Therapy with antihistamines should be administered cautiously in such patients. Lower initial dosages may be appropriate.

References

  1. Glazko AJ, Dill WA, Young RM, Smith TC, Ogilvie RI (1974) "Metabolic disposition of diphenhydramine." Clin Pharmacol Ther, 16, p. 1066-76
  2. Paton DM, Webster DR (1985) "Clinical pharmacokinetics of H1-receptor antagonists (the antihistamines)." Clin Pharmacokinet, 10, p. 477-97
  3. Rumore MM (1984) "Clinical pharmacokinetics of chlorpheniramine." Drug Intell Clin Pharm, 18, p. 701-7
  4. Huang SM, Athanikar NK, Sridhar K, Huang YC, Chiou WL (1982) "Pharmacokinetics of chlorpheniramine after intravenous and oral administration in normal adults." Eur J Clin Pharmacol, 22, p. 359-65
  5. Simons KJ, Simons FE, Luciuk GH, Frith EM (1984) "Urinary excretion of chlorpheniramine and its metabolites in children." J Pharm Sci, 73, p. 595-9
  6. Meredith CG, Christian CD Jr, Johnson RF, Madhavan SV, Schenker S (1984) "Diphenhydramine disposition in chronic liver disease." Clin Pharmacol Ther, 35, p. 474-9
  7. Blyden GT, Greenblatt DJ, Scavone JM, Shader RI (1986) "Pharmacokinetics of diphenhydramine and a demethylated metabolite following intravenous and oral administration." J Clin Pharmacol, 26, p. 529-33
  8. Albert KS, Hallmark MR, Sakmar E, Weidler DJ, Wagner JG (1975) "Pharmacokinetics of diphenhydramine in man." J Pharmacokinet Biopharm, 3, p. 159-70
  9. Simons FE, Frith EM, Simons KJ (1982) "The pharmacokinetics and antihistaminic effects of brompheniramine." J Allergy Clin Immunol, 70, p. 458-64
  10. Bruce RB, Turnbull LB, Newman JH, Pitts JE (1968) "Metabolism of brompheniramine." J Med Chem, 11, p. 1031-4
  11. Porter CC, Arison BH, Gruber VF, Titus DC, Vandenheuvel WJ (1975) "Human metabolism of cyproheptadine." Drug Metab Dispos, 3, p. 189-97
  12. Hintze KL, Wold JS, Fischer LJ (1975) "Disposition of cyproheptadine in rats, mice, and humans and identification of a stable epoxide metabolite." Drug Metab Dispos, 3, p. 1-9
  13. Maddox DE, Reed CE (1987) "Clinical pharmacodynamics of antihistamines." Ann Allergy, 59, p. 43-8
  14. Simons FE, Simons KJ, Frith EM (1984) "The pharmacokinetics and antihistaminic of the H1 receptor antagonist hydroxyzine." J Allergy Clin Immunol, 73, p. 69-75
  15. Simons FE, Watson WT, Chen XY, Minuk GY, Simons KJ (1989) "The pharmacokinetics and pharmacodynamics of hydroxyzine in patients with primary biliary cirrhosis." J Clin Pharmacol, 29, p. 809-15
View all 15 references
Moderate

Anxiolytics/sedatives/hypnotics (applies to Vistaril) glaucoma

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Glaucoma/Intraocular Hypertension, Urinary Retention

Some hypnotic drugs can have an anticholinergic effect and should be used with caution in patients with glaucoma, and trouble urinating due to retention or enlarged prostate.

References

  1. (2002) "Product Information. Benadryl (diphenhydramine)." Parke-Davis
  2. (2013) "Product Information. Unisom (doxylamine)." Pfizer U.S. Pharmaceuticals Group
Moderate

Anxiolytics/sedatives/hypnotics (applies to Vistaril) liver disease

Moderate Potential Hazard, Moderate plausibility.

In general, anxiolytics, sedatives and hypnotics are extensively metabolized by the liver. Their plasma clearance may be decreased and their half-life prolonged in patients with impaired hepatic function. Therapy with these drugs should be administered cautiously in patients with liver disease (some are not recommended in severe liver impairment), and the dosage should be adjusted accordingly. Laboratory testing is recommended prior and during treatment.

References

  1. (2002) "Product Information. Buspar (buspirone)." Bristol-Myers Squibb
  2. (2001) "Product Information. Placidyl (ethchlorvynol)." Abbott Pharmaceutical
  3. (2001) "Product Information. Aquachloral Supprettes (chloral hydrate)." Medisca Inc
  4. (2001) "Product Information. Equanil (meprobamate)." Wallace Laboratories
  5. (2001) "Product Information. Sonata (zaleplon)." Wyeth-Ayerst Laboratories
  6. (2001) "Product Information. Precedex (dexmedetomidine)." Abbott Pharmaceutical
  7. (2002) "Product Information. Xyrem (sodium oxybate)." Orphan Medical
  8. (2004) "Product Information. Lunesta (eszopiclone)." Sepracor Inc
  9. (2005) "Product Information. Rozerem (ramelteon)." Takeda Pharmaceuticals America
  10. (2010) "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals
  11. (2011) "Product Information. Intermezzo (zolpidem)." Purdue Pharma LP
  12. (2014) "Product Information. Hetlioz (tasimelteon)." Vanda Pharmaceuticals Inc
  13. (2014) "Product Information. Belsomra (suvorexant)." Merck & Co., Inc
View all 13 references
Moderate

Anxiolytics/sedatives/hypnotics (applies to Vistaril) renal/liver disease

Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Renal Dysfunction

Some anxiolytics, sedatives and hypnotics are extensively metabolized by the liver, and excreted in the urine. Patients with impaired renal and/or hepatic function may be at greater risk for adverse effects, including central nervous system and respiratory depression, due to drug and metabolite accumulation. Therapy with these drugs should be administered cautiously in such patients, with careful dose selection usually starting at the low end of the dosing range.

References

  1. (2001) "Product Information. Equanil (meprobamate)." Wallace Laboratories
  2. (2001) "Product Information. Atarax (hydroxyzine)." Pfizer U.S. Pharmaceuticals
  3. (2010) "Product Information. Silenor (doxepin)." Somaxon Pharmaceuticals

Vistaril drug interactions

There are 581 drug interactions with Vistaril (hydroxyzine).

Vistaril alcohol/food interactions

There is 1 alcohol/food interaction with Vistaril (hydroxyzine).


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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.