Indications

Artica Hydrochloride is indicated for:

• Symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease where anxiety is present.
• Management of itching (pruritus) caused by allergic conditions like chronic urticaria, atopic and contact dermatoses, and histamine-mediated pruritus.
• Sedation when used as a premedication and following general anesthesia. The long-term effectiveness of Artica for anxiety (over 4 months) has not been systematically studied, and a physician should periodically reassess its usefulness for the patient.

Pharmacology

Hydroxyzine Hydrochloride is an anxiolytic antihistamine that works as a histamine H1 receptor antagonist. Its effects are not due to cortical depression but rather a suppression of activity in specific subcortical areas of the central nervous system. The drug also has been shown to have skeletal muscle relaxant, bronchodilator, antihistaminic, analgesic, and antiemetic properties. It is rapidly absorbed from the gastrointestinal tract, with clinical effects typically appearing within 15-30 minutes after oral administration.

Dosage & Administration

• Symptomatic relief of anxiety and tension:
  • Adults: 50-100 mg four times a day.
  • Children (>6 years): 50-100 mg daily in divided doses.
  • Children (<6 years): 50 mg daily in divided doses.
• Pruritus (itching) due to allergic conditions:
  • Adults: 25 mg three to four times a day.
  • Children (>6 years): 50-100 mg daily in divided doses.
  • Children (<6 years): 50 mg daily in divided doses.
• As a sedative (premedication and following general anesthesia):
  • Adults: 50-100 mg.
  • Children: 0.6 mg per kg of body weight.

Interaction

Artica can potentiate the effects of meperidine and barbiturates, so their dosages should be adjusted if used together. It does not interfere with atropine or digitalis. It should not be used at the same time as monoamine oxidase inhibitors.

Contraindications

Hydroxyzine is contraindicated in patients with a known hypersensitivity to Hydroxyzine or any of its ingredients.

Side Effects

Side effects are usually mild and temporary. The most common ones include drowsiness, headache, psychomotor impairment, and antimuscarinic effects such as urinary retention, dry mouth, and blurred vision. Less common side effects include low blood pressure, heart palpitations, irregular heart rhythm, dizziness, confusion, tremors, convulsions, and allergic reactions.

Pregnancy & Lactation

Clinical data on the safety of Hydroxyzine in early pregnancy are insufficient. Therefore, it is contraindicated during early pregnancy. It is not known if the drug is excreted in human milk, so it should not be given to nursing mothers.

Precautions & Warnings

Because Artica can increase the effects of central nervous system depressants (like narcotics and barbiturates), their dosages should be reduced when used together. Due to the possibility of drowsiness, patients should be warned against driving or operating dangerous machinery. Patients should also be cautioned against using other CNS depressants or drinking alcohol, as the effects may be enhanced.

Use in Special Populations

• Renal Impairment: Patients with kidney impairment should be given half of the normal dose.
• Elderly Patients: It is recommended to start with half the recommended dose for elderly patients due to the drug's prolonged action.

Overdose Effects

The most common sign of an overdose is extreme sedation. In case of an overdose, it is important to remember that multiple drugs may have been taken. Treatment includes inducing vomiting or gastric lavage, general supportive care, and monitoring vital signs. Low blood pressure can be managed with intravenous fluids and other medications, but epinephrine should be avoided as Artica counteracts its effects. There is no specific antidote, and it is unlikely that hemodialysis would be effective.

Therapeutic Class

Artica is a sedating antihistamine.

Storage Conditions

Store in a cool and dry place. Protect from light. Keep out of the reach of children.