Comparative Pharmacology
Head-to-head clinical analysis: AZELASTINE HYDROCHLORIDE CHILDREN S ALLERGY versus HYDROXYZINE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: AZELASTINE HYDROCHLORIDE CHILDREN S ALLERGY versus HYDROXYZINE.
AZELASTINE HYDROCHLORIDE CHILDREN'S ALLERGY vs HYDROXYZINE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Azelastine hydrochloride is a phthalazinone derivative that acts as a selective histamine H1-receptor antagonist. It inhibits the release of histamine and other mediators from mast cells, reduces chemotaxis, and decreases eosinophil activation. It also suppresses leukotriene and cytokine production.
Hydroxyzine is a first-generation antihistamine that acts as a competitive antagonist at histamine H1 receptors in the gastrointestinal tract, blood vessels, and respiratory tract. It also exhibits sedative, anxiolytic, and antiemetic properties, possibly through central nervous system depression and anticholinergic effects.
Azelastine hydrochloride nasal spray: 1 spray (137 mcg) per nostril twice daily; maximum 2 sprays per nostril twice daily.
25-100 mg orally 3-4 times daily; 50-100 mg IM every 4-6 hours as needed. Maximum oral dose: 600 mg/day in divided doses.
None Documented
None Documented
Clinical Note
moderateHydroxyzine + Venlafaxine
"The risk or severity of adverse effects can be increased when Hydroxyzine is combined with Venlafaxine."
Clinical Note
moderateHydroxyzine + Nefazodone
"The risk or severity of adverse effects can be increased when Hydroxyzine is combined with Nefazodone."
Clinical Note
moderateHydroxyzine + Mifepristone
"Hydroxyzine may increase the QTc-prolonging activities of Mifepristone."
Clinical Note
moderateHydroxyzine + Fesoterodine
Terminal elimination half-life is 22–25 hours in adults; steady state achieved in 3–5 days. In children (6–11 years), half-life is similar (mean 22 hours).
Terminal elimination half-life: 14-25 hours (mean ~20 h). In elderly or hepatic impairment, may be prolonged; antihistamine effect persists beyond half-life due to active metabolite.
Primarily renal (approximately 75%), with about 50% as unchanged drug and 25% as metabolites via CYP3A4 and CYP2D6. Fecal excretion accounts for ~20%.
Renal: approximately 70% as metabolites, less than 1% unchanged. Fecal/biliary: minor. Cetirizine (active metabolite) also renally eliminated.
Category C
Category A/B
Antihistamine
Antihistamine
"The serum concentration of the active metabolites of Fesoterodine can be increased when Fesoterodine is used in combination with Hydroxyzine."