Hydroxyzine overdose

Vistaril overdose

Hydroxyzine is an antihistamine available only with a prescription. It is used to treat symptoms of allergies and motion sickness.

Hydroxyzine overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

This article is for information only. DO NOT use it to treat or manage an actual overdose. If you or someone you are with has an overdose, call your local emergency number (such as 911), or your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Poisonous Ingredient

Hydroxyzine can be harmful in large amounts.

Where Found

Hydroxyzine is found in medicines with these names:

Durrax
Rezine
Vistaril
Multipax

Other medicines may also contain hydroxyzine.

Symptoms

Dilated pupils are the classic symptom of a hydroxyzine overdose. Below are other symptoms of a hydroxyzine overdose in different parts of the body.

AIRWAYS AND LUNGS

Shortness of breath

BLADDER AND KIDNEYS

Difficulty urinating

EYES, EARS, NOSE, THROAT, AND MOUTH

HEART AND BLOOD

NERVOUS SYSTEM

Agitation
Coma (decreased level of consciousness and lack of responsiveness)
Seizures
Delirium
Depression
Disorientation
Dizziness
Drowsiness
Hallucinations (seeing or hearing things that aren't there)
Nervousness
Sleeping difficulties
Tremor
Uncoordinated movement
Unsteadiness

SKIN

Dry, red, or flushed skin

STOMACH AND INTESTINES

Nausea
Vomiting

Before Calling Emergency

Have this information ready:

Person's age, weight, and condition
Name of the product (ingredients and strength, if known)
Time it was swallowed
Amount swallowed
If the medicine was prescribed for the person

Poison Control

Your local poison control center can be reached directly by calling the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States. This national hotline will let you talk to experts in poisoning. They will give you further instructions.

This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

What to Expect at the Emergency Room

Take the container to the hospital with you, if possible.

The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may done include:

Blood and urine tests
Chest x-ray
Electrocardiogram (ECG)

Treatment may include:

Fluids through a vein (by IV)
Medicines to treat symptoms
Activated charcoal
Laxative
Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator)

Outlook (Prognosis)

Recovery is likely if the person survives the first 24 hours. Complications such as pneumonia, muscle damage from lying on a hard surface for a prolonged period of time, or brain damage from lack of oxygen may cause permanent disability. Few people actually die from an antihistamine overdose, unless they have serious heart rhythm disturbances or breathing problems.

Keep all medicines in child-proof bottles and out of reach of children.

References

Aronson JK. Anticholinergic drugs. In: Aronson JK, ed. Meyler's Side Effects of Drugs. 16th ed. Waltham, MA: Elsevier; 2016:534-539.

Hoppe JA, Monte AA. Anticholinergics. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 140.

Version Info

Last reviewed on: 11/2/2023

Reviewed by: Jesse Borke, MD, CPE, FAAEM, FACEP, Attending Physician at Kaiser Permanente, Orange County, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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