Antihistamines are often the first line of treatment or medications prescribed for treating itching caused by allergies. A medication of this category that used to be frequently recommended is Atarax, a branded formulation of the generic drug hydroxyzine. The antihistamine was primarily used to treat itching add also used to relieve symptoms of anxiety and tension, including nervousness and irritability. Atarax was also prescribed as a sedative prior to surgery to help control nausea and vomiting. However, the drug has hence been discontinued and following subsections offer a deeper look at the drug, including answers to the question – why was Atarax discontinued? Though Atarax is recommended for multiple uses, its primary indication is for relief from itching.
Mechanism of action of Atarax
Atarax works through its antagonism of histamine H1 receptors. It competes with histamine for binding at these receptors, effectively blocking the action of histamine. Histamine, a substance released by the body during allergic reactions, causes various symptoms such as itching, sneezing, runny nose, and watery eyes. By blocking the H1 receptors, Atarax reduces the effects of histamine and helps alleviate allergic symptoms. Apart from antihistamine properties, Atarax also exhibits anti-anxiety and sedative effects. These effects are believed to be mediated through interactions with other neurotransmitter systems, including serotonin and acetylcholine receptors. Atarax’s mechanism of action involves its dual effects as an H1 receptor antagonist and a modulator of other neurotransmitter systems, offering relief from allergic symptoms, anxiety, and tension.
Side effects of Atarax
All medications come with the possibility of undesirable outcomes and Atarax is no exception. The antihistamine can cause several side effects, though all users are unlikely to experience side effects. Additionally, the intensity and duration of reactions may differ. Commonly reported side effects of Atarax include the following:
- The antihistamine has a sedative effect and can cause drowsiness, making it important to avoid activities requiring mental alertness, such as driving or operating heavy machinery.
- Atarax is known to reduce saliva production, leading to a dry or parched feeling in the mouth. Chewing sugar-free gum or using saliva substitutes can help alleviate this symptom.
- The drug can temporarily affect vision and cause blurred vision. Individuals on the medication are to avoid tasks that require clear vision until the effects subside.
- There is a possibility of experiencing dizziness or lightheadedness while taking Atarax, and individuals are advised to raise slowly from a sitting or lying position to minimize the risk of falls.
- In rare instances, Atarax can cause difficulty in passing urine or urinary retention.
- Atarax may also cause gastrointestinal side effects such as nausea, vomiting, and stomach discomfort. This is typically avoided by taking the medication with food.
- A small section of individuals may experience headaches while taking Atarax, and persistent or severe headaches may require medical attention.
Possible drug interactions of Atarax
In addition to the above side effects, Atarax can potentially interact with other medications, substances, or medical conditions. Patients are to intimate healthcare providers about all medications in use, including prescription, over-the-counter drugs, and herbal supplements. Commonly reported drug interactions associated with Atarax include the following:
- Atarax has sedative effects, and when taken along with other Central Nervous System (CNS) Depressants such as alcohol, opioids, benzodiazepines, or certain antidepressants, it can increase the risk of excessive sedation and respiratory depression.
- The anticholinergic properties of the antihistamine, when combined with other medications that also have anticholinergic effects, such as some antidepressants, antipsychotics, or antiparkinsonian drugs, can intensify the anticholinergic side effects like dry mouth, blurred vision, urinary retention, and constipation.
- When Atarax is combined with Monoamine Oxidase Inhibitors (MAOIs), a class of antidepressants, this can result in serious and potentially life-threatening reactions such as hypertensive crisis. It is essential to ensure a sufficient washout period between using Atarax and MAOIs.
- Atarax has the potential to prolong the QT interval, which can increase the risk of life-threatening heart arrhythmias. Use of Atarax with other QT Prolonging Drugs, such as certain antiarrhythmics, antipsychotics, and antibiotics, requires constant monitoring.
- The antihistamine may antagonize the effects of sympathomimetic drugs, such as epinephrine or adrenaline, used for the treatment of severe allergic reactions. This can reduce the effectiveness of the above mentioned emergency medications.
Efficacy of Atarax
Atarax has demonstrated efficacy in various clinical conditions for which it is commonly prescribed. Its effectiveness can vary depending on the specific condition being treated and individual patient response. Here are some areas where Atarax has been found to be effective, during the studies:
- Allergic conditions: Atarax is primarily used to relieve itching caused by allergic reactions. It works by blocking histamine receptors, which helps reduce itching, sneezing, runny nose, and other allergy symptoms. It is often used in the treatment of allergic dermatitis, hives, and allergic rhinitis.
- Anxiety and tension: Atarax has anxiolytic properties and can help alleviate symptoms of anxiety and tension. It may be prescribed for short-term relief of anxiety symptoms or as an adjunctive treatment in anxiety disorders. However, it is not typically considered a first-line treatment for chronic anxiety disorders.
- Sedation: Atarax has sedative effects, and it is sometimes used as a short-term sedative before surgical procedures or to manage insomnia. Its sedating properties can also be helpful in managing anxiety-related sleep disturbances.
Manufacturer of Atarax and why was Atarax discontinued?
Atarax was originally developed and manufactured by Union Chimique Belge Pharma in 1956. As the drug was a branded formulation of the generic drug hydroxyzine, pharmaceutical companies with different subsidiaries and manufacturing agreements in different regions, the name varied depending on the country or region. Atarax was approved for sale by Pfizer in the United States later and was a frequently recommended or prescribed medication. However, it was discontinued in the US mainly for commercial considerations – the drug became an uneconomically viable product line for the manufacturer and ended up being discontinued. It is important to emphasize here that Atarax was not removed from the market for safety or effectiveness reasons, according to the FDA. A generic version of Atarax known as hydroxyzine hydrochloride is presently available in the US and is reasonably priced.