Hydroxyzine overdose

Hydroxyzine can be harmful in large amounts.

Hydroxyzine is found in medicines with these names:

• Durrax
• Rezine
• Vistaril

Other medicines may also contain hydroxyzine.

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

• Blurred vision
• Dry mouth
• Enlarged pupils
• Dry eyes
  
• Ringing in the ears

HEART AND BLOOD

• Rapid heartbeat
• Low blood pressure
• Pounding heartbeat (palpitations)

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

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

The 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.

You can also get online poison help now at Poisonhelp.org. Just enter the product, poison, or medicine to get expert help.

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

Your health care provider will measure and monitor your vital signs, including temperature, pulse, breathing rate, and blood pressure.

Tests that may done include:

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

• 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)

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.

Vistaril overdose

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.

Meehan TJ. Care of the poisoned patient. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 135.

Nelson LS, Calello DP. Acute poisoning. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 96.

Updated 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.