A-Calm
Generic Name
Hydroxyzine Hydrochloride
Manufacturer
Hypothetical Pharma Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| a calm 50 mg tablet | ৳ 8.00 | ৳ 80.00 |
Description
Overview of the medicine
A-Calm 50 mg Tablet contains Hydroxyzine Hydrochloride, an antihistamine with sedative, anxiolytic, and antiemetic properties. It is primarily used for the management of anxiety, pruritus (itching), and as a pre-operative sedative.
Uses & Indications
Dosage
Adults
For anxiety: 50-100 mg daily in divided doses. For pruritus: 25-100 mg daily in divided doses. For sedation: 50-100 mg single dose.
Elderly
Initiate at a lower dose, typically 25 mg daily, and adjust based on response and tolerability due to increased sensitivity and risk of side effects.
Renal_impairment
Dose adjustment required. For severe impairment (CrCl < 10 mL/min), dose should be reduced by 50%.
Hepatic_impairment
Dose adjustment required. Reduce dose by 33% in patients with hepatic impairment.
How to Take
Take orally with or without food. Swallow the tablet whole with a glass of water. Do not crush or chew.
Mechanism of Action
Hydroxyzine acts primarily as an H1-receptor antagonist, leading to central nervous system depression, which accounts for its sedative and anxiolytic effects. It also has anticholinergic, antiemetic, and mild analgesic properties.
Pharmacokinetics
Onset
15-30 minutes for sedative and anxiolytic effects.
Excretion
Mainly excreted in urine as metabolites, with some biliary excretion.
Half life
Plasma elimination half-life ranges from 7 to 24 hours, highly variable among individuals.
Absorption
Rapidly absorbed from the gastrointestinal tract; peak plasma concentrations achieved within 2 hours.
Metabolism
Primarily hepatic, metabolized by alcohol dehydrogenase to cetirizine (active metabolite), which is also an antihistamine.
Side Effects
Contraindications
- Hypersensitivity to hydroxyzine, cetirizine, levocetirizine, or any components of the formulation
- Patients with known prolonged QT interval
- History of Torsade de Pointes
- Porphyria
- Early pregnancy and lactation
Drug Interactions
CNS Depressants
Potentiates the effects of alcohol, sedatives, hypnotics, and other CNS depressants.
Anticholinergics
May enhance anticholinergic effects (e.g., dry mouth, blurred vision, constipation).
QT-prolonging drugs
Concurrent use with drugs known to prolong the QT interval (e.g., antiarrhythmics, antipsychotics, certain antibiotics) should be avoided due to increased risk of cardiac arrhythmias.
Storage
Store below 30°C in a cool, dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include CNS depression (somnolence, coma), anticholinergic effects (dry mouth, blurred vision, tachycardia), hypotension, and rarely, seizures or cardiac arrhythmias. Treatment is supportive, involving gastric lavage/activated charcoal, and monitoring vital signs and ECG.
Pregnancy & Lactation
Pregnancy Category C. Should not be used during early pregnancy due to potential teratogenic effects. Excreted into breast milk; therefore, contraindicated during lactation.
Side Effects
Contraindications
- Hypersensitivity to hydroxyzine, cetirizine, levocetirizine, or any components of the formulation
- Patients with known prolonged QT interval
- History of Torsade de Pointes
- Porphyria
- Early pregnancy and lactation
Drug Interactions
CNS Depressants
Potentiates the effects of alcohol, sedatives, hypnotics, and other CNS depressants.
Anticholinergics
May enhance anticholinergic effects (e.g., dry mouth, blurred vision, constipation).
QT-prolonging drugs
Concurrent use with drugs known to prolong the QT interval (e.g., antiarrhythmics, antipsychotics, certain antibiotics) should be avoided due to increased risk of cardiac arrhythmias.
Storage
Store below 30°C in a cool, dry place. Protect from light and moisture. Keep out of reach of children.
Overdose
Symptoms include CNS depression (somnolence, coma), anticholinergic effects (dry mouth, blurred vision, tachycardia), hypotension, and rarely, seizures or cardiac arrhythmias. Treatment is supportive, involving gastric lavage/activated charcoal, and monitoring vital signs and ECG.
Pregnancy & Lactation
Pregnancy Category C. Should not be used during early pregnancy due to potential teratogenic effects. Excreted into breast milk; therefore, contraindicated during lactation.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture, depending on storage conditions.
Availability
Available in pharmacies, hospitals, and clinics
Approval Status
Approved by regulatory authorities worldwide
Patent Status
Generic available
WHO Essential Medicine
YesClinical Trials
Hydroxyzine has been widely studied in numerous clinical trials demonstrating its efficacy in anxiety, pruritus, and sedation. Ongoing research may explore specific pharmacogenomic responses.
Lab Monitoring
- Baseline and periodic ECG monitoring, especially in patients with cardiac risk factors or concomitant use of QT-prolonging drugs.
- Liver and renal function tests for patients with impairment.
Doctor Notes
- Advise patients regarding potential for drowsiness and impaired cognitive/motor function.
- Assess patient's cardiac risk factors (e.g., family history of long QT syndrome) before initiating treatment.
- Consider lower doses in elderly and renally/hepatically impaired patients.
- Counsel patients on avoiding alcohol and other CNS depressants.
Patient Guidelines
- Do not exceed the prescribed dose.
- Avoid alcohol and other CNS depressants.
- Report any new or worsening side effects to your doctor.
- Do not stop taking this medicine abruptly without consulting your doctor.
- Be aware of potential drowsiness and impaired coordination.
Missed Dose Advice
If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
This medicine can cause drowsiness, dizziness, and blurred vision, which may impair your ability to drive or operate machinery. Avoid these activities until you know how the medicine affects you.
Lifestyle Advice
- Avoid activities requiring mental alertness, such as driving or operating heavy machinery, especially when first starting treatment or after a dose increase.
- Maintain adequate hydration to alleviate dry mouth.
- Avoid sudden changes in posture to prevent dizziness.
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