Antipru

Calamine (Antipru) is a mixture of zinc oxide (ZnO) with about 0.5% iron(III) oxide (Fe2O3). It is the main ingredient in Calamine (Antipru) lotion and is used as an antipruritic (anti-itching agent) to treat mild pruritic conditions such as sunburn, eczema, rashes, poison ivy, chickenpox, insect bites and stings. It is also used as a mild antiseptic to prevent infections that can be caused by scratching the affected area, and an astringent to dry weeping or oozing blisters and acne abscesses.

Diphenhydramine (Antipru) is used to treat hypertension and edema. Like other thiazides, benzthiazide promotes water loss from the body (diuretics). They inhibit Na+/Cl- reabsorption from the distal convoluted tubules in the kidneys. Thiazides also cause loss of potassium and an increase in serum uric acid. Thiazides are often used to treat hypertension, but their hypotensive effects are not necessarily due to their diuretic activity. Thiazides have been shown to prevent hypertension-related morbidity and mortality although the mechanism is not fully understood. Thiazides cause vasodilation by activating calcium-activated potassium channels (large conductance) in vascular smooth muscles and inhibiting various carbonic anhydrases in vascular tissue.

Each Hydroxyzine (Antipru) tablet contains Hydroxyzine (Antipru) diHCl 10 mg or 25 mg.

Each mL of Hydroxyzine (Antipru) syrup contains hydrozyxine diHCl 2 mg.

Topical anesthetics are used to relieve pain and itching caused by conditions such as sunburn or other minor burns, insect bites or stings, poison ivy, poison oak, poison sumac, and minor cuts and scratches. Pramocaine is also common ingredients in over the counter hemorrhoid preparations.

Diphenhydramine (Antipru) in the injectable form is effective in adults and pediatric patients, other than premature infants and neonates, for the following conditions when Diphenhydramine (Antipru) in the oral form is impractical.

Antihistaminic

For amelioration of allergic reactions to blood or plasma, in anaphylaxis as an adjunct to epinephrine and other standard measures after the acute symptoms have been controlled, and for other uncomplicated allergic conditions of the immediate type when oral therapy is impossible or contraindicated.

Motion sickness

For active treatment of motion sickness.

Antiparkinsonism

For use in parkinsonism, when oral therapy is impossible or contraindicated, as follows: parkinsonism in the elderly who are unable to tolerate more potent agents; mild cases of parkinsonism in other age groups, and in other cases of parkinsonism in combination with centrally acting anticholinergic agents.

For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested.

Useful in the management of pruritus due to allergic conditions such as chronic urticaria and atopic and contact dermatoses, and in histamine-mediated pruritus.

As a sedative when used as premedication and following general anesthesia, Hydroxyzine (Antipru) may potentiate meperidine (Demerol®) and barbiturates, so their use in pre-anesthetic adjunctive therapy should be modified on an individual basis. Atropine and other belladonna alkaloids are not affected by the drug. Hydroxyzine (Antipru) is not known to interfere with the action of digitalis in any way and it may be used concurrently with this agent.

The effectiveness of Hydroxyzine (Antipru) as an antianxiety agent for long-term use, that is, more than 4 months, has not been assessed by systematic clinical studies. The physician should reassess periodically the usefulness of the drug for the individual patient.

Calamine (Antipru) is an anti-itch medicine that works by causing a cooling sensation as it evaporates on your skin. Calamine (Antipru) also dries oozing or weeping from minor skin irritation.

Calamine (Antipru) topical (for the skin) is used to treat itching and skin irritation caused by chickenpox, insect bites or stings, measles, eczema, sunburn, poison ivy, and other minor skin conditions.

Calamine (Antipru) topical may also be used for purposes not listed in this medication guide.

Diphenhydramine (Antipru) is an antihistamine. Diphenhydramine (Antipru) blocks the effects of the naturally occurring chemical histamine in the body.

Diphenhydramine (Antipru) is used to treat sneezing; runny nose; itching, watery eyes; hives; rashes; itching; and other symptoms of allergies and the common cold.

Diphenhydramine (Antipru) is also used to suppress coughs, to treat motion sickness, to induce sleep, and to treat mild forms of Parkinson's disease.

Diphenhydramine (Antipru) may also be used for purposes other than those listed in this medication guide.

Hydroxyzine (Antipru) injection is used to used to help control anxiety and tension caused by dental, nervous, and emotional conditions. It can also be used to help control anxiety and produce sleep before and after surgery. Hydroxyzine (Antipru) is also used to relieve symptoms of an allergic reaction (eg, hives, itching skin) caused by asthma and chronic urticaria.

Hydroxyzine (Antipru) is an antihistamine. It works by preventing the effects of a substance called histamine, which is produced by the body. Hydroxyzine (Antipru) is also used to control anxiety withdrawal symptoms in alcoholic patients. It is also used to control nausea and vomiting symptoms, and relieve anxiety in patients with certain heart disease.

Hydroxyzine (Antipru) is to be given by or under the supervision of your doctor.

Usual Adult Dose for Pain:

Itching and pain associated with rashes due to poison ivy, poison oak or poison sumac, insect bites, and minor skin irritations or minor cuts:

Apply topically to affected area not more than 3 to 4 times daily

Usual Adult Dose for Pruritus:

Itching and pain associated with rashes due to poison ivy, poison oak or poison sumac, insect bites, and minor skin irritations or minor cuts:

Apply topically to affected area not more than 3 to 4 times daily

Usual Pediatric Dose for Pain:

Itching and pain associated with rashes due to poison ivy, poison oak or poison sumac, insect bites, and minor skin irritations or minor cuts:

2 years or older:

Apply topically to affected area not more than 3 to 4 times daily

Usual Pediatric Dose for Pruritus:

Itching and pain associated with rashes due to poison ivy, poison oak or poison sumac, insect bites, and minor skin irritations or minor cuts:

2 years or older:

Apply topically to affected area not more than 3 to 4 times daily

Usual Adult Dose for Insomnia

Note: Acetaminophen-Diphenhydramine (Antipru) is generally dosed based on the Diphenhydramine (Antipru) component to equal 50 mg of Diphenhydramine (Antipru) (76 mg Diphenhydramine (Antipru) citrate) at bedtime.

Acetaminophen-Diphenhydramine (Antipru) comes in several different dosages (500 mg-25 mg, 650 mg-50 mg, 500 mg-38 mg, 500 mg-12.5 mg, 1000 mg-50 mg, 500 mg-50 mg, 325 mg-12.5 mg) and is available as liquid, caplets, geltabs, and gelcaps. The manufacturer of these products generally advises 2 dosage units at bedtime or as directed by a healthcare professional.

Usual Adult Dose for Pain

Note: Acetaminophen-Diphenhydramine (Antipru) is generally dosed based on the Diphenhydramine (Antipru) component to equal 50 mg of Diphenhydramine (Antipru) (76 mg Diphenhydramine (Antipru) citrate) at bedtime.

Acetaminophen-Diphenhydramine (Antipru) comes in several different dosages (500 mg-25 mg, 650 mg-50 mg, 500 mg-38 mg, 500 mg-12.5 mg, 1000 mg-50 mg, 500 mg-50 mg, 325 mg-12.5 mg) and is available as liquid, caplets, geltabs, and gelcaps. The manufacturer of these products generally advises 2 dosage units at bedtime or as directed by a healthcare professional.

Usual Adult Dose for Headache

Note: Acetaminophen-Diphenhydramine (Antipru) is generally dosed based on the Diphenhydramine (Antipru) component to equal 50 mg of Diphenhydramine (Antipru) (76 mg Diphenhydramine (Antipru) citrate) at bedtime.

Acetaminophen-Diphenhydramine (Antipru) comes in several different dosages (500 mg-25 mg, 650 mg-50 mg, 500 mg-38 mg, 500 mg-12.5 mg, 1000 mg-50 mg, 500 mg-50 mg, 325 mg-12.5 mg) and is available as liquid, caplets, geltabs, and gelcaps. The manufacturer of these products generally advises 2 dosage units at bedtime or as directed by a healthcare professional.

Usual Pediatric Dose for Insomnia

Greater than or equal to 12 years:

Note: Acetaminophen-Diphenhydramine (Antipru) is generally dosed based on the Diphenhydramine (Antipru) component to equal 50 mg of Diphenhydramine (Antipru) (76 mg Diphenhydramine (Antipru) citrate) at bedtime.

Acetaminophen-Diphenhydramine (Antipru) comes in several different dosages (500 mg-25 mg, 650 mg-50 mg, 500 mg-38 mg, 500 mg-12.5 mg, 1000 mg-50 mg, 500 mg-50 mg, 325 mg-12.5 mg) and is available as liquid, caplets, geltabs, and gelcaps. The manufacturer of these products generally advises 2 dosage units at bedtime or as directed by a healthcare professional.

Usual Pediatric Dose for Pain

Greater than or equal to 12 years:

Note: Acetaminophen-Diphenhydramine (Antipru) is generally dosed based on the Diphenhydramine (Antipru) component to equal 50 mg of Diphenhydramine (Antipru) (76 mg Diphenhydramine (Antipru) citrate) at bedtime.

Acetaminophen-Diphenhydramine (Antipru) comes in several different dosages (500 mg-25 mg, 650 mg-50 mg, 500 mg-38 mg, 500 mg-12.5 mg, 1000 mg-50 mg, 500 mg-50 mg, 325 mg-12.5 mg) and is available as liquid, caplets, geltabs, and gelcaps. The manufacturer of these products generally advises 2 dosage units at bedtime or as directed by a healthcare professional.

Usual Pediatric Dose for Headache

Greater than or equal to 12 years:

Note: Acetaminophen-Diphenhydramine (Antipru) is generally dosed based on the Diphenhydramine (Antipru) component to equal 50 mg of Diphenhydramine (Antipru) (76 mg Diphenhydramine (Antipru) citrate) at bedtime.

Acetaminophen-Diphenhydramine (Antipru) comes in several different dosages (500 mg-25 mg, 650 mg-50 mg, 500 mg-38 mg, 500 mg-12.5 mg, 1000 mg-50 mg, 500 mg-50 mg, 325 mg-12.5 mg) and is available as liquid, caplets, geltabs, and gelcaps. The manufacturer of these products generally advises 2 dosage units at bedtime or as directed by a healthcare professional.

Renal Dose Adjustments

Data not available

Liver Dose Adjustments

Use with caution in patients with liver disease. Chronic use of acetaminophen is not recommended in patients with liver disease.

Precautions

Patients who consume three or more alcohol containing drinks per day should be informed to consult with their physician for advice on when and how to take acetaminophen. Chronic, heavy alcohol users may be at increased risk of liver damage when taking more than recommended dosages.

Patients and adults taking care of children should be advised to consult with their doctor before continuing to use acetaminophen if symptoms of illness worsen. Although rare, there is the possibility of acetaminophen intoxication on chronic use of the drug, and the symptoms seen during the first phase of intoxication (nausea, vomiting, anorexia, malaise, and diaphoresis) may trigger the use of more doses.

Patients should be warned of the sedative effects of Diphenhydramine (Antipru), and advised not to take this drug with alcohol.

Due to the anticholinergic effect of Diphenhydramine (Antipru), it should be used with caution in patients with narrow-angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction, prostatic hypertrophy or bladder neck obstructions. It should also be used with caution in patients with increased intraocular pressure, hyperthyroidism, cardiovascular disease, or hypertension.

Dialysis

Data not available

For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested: in adults, 50-100 mg q.i.d.; children under 6 years, 50 mg daily in divided doses; and over 6 years, 50-100 mg daily in divided doses.

For use in the management of pruritus due to allergic conditions such as chronic urticaria and atopic and contact dermatoses, and in histamine-mediated pruritus: in adults, 25 mg t.i.d. or q.i.d.; children under 6 years, 50 mg daily in divided doses; and over 6 years, 50-100 mg daily in divided doses.

As a sedative when used as a premedication and following general anesthesia: 50-100 mg in adults, and 0.6 mg/kg in children.

When treatment is initiated by the intramuscular route of administration, subsequent doses may be administered orally.

As with all medications, the dosage should be adjusted according to the patient's response to therapy.

How supplied

Hydroxyzine (Antipru)® Capsules (Hydroxyzine (Antipru) pamoate equivalent to Hydroxyzine (Antipru) hydrochloride)

25 mg: 100's (NDC 0069-5410-66), two-tone green capsules

50 mg: 100's (NDC 0069-5420-66), green and white capsules

Hydroxyzine (Antipru)®

Oral Suspension (Hydroxyzine (Antipru) pamoate equivalent to 25 mg Hydroxyzine (Antipru) hydrochloride per teaspoonful-5 mL): 1 pint (473 mL) bottles (NDC 0069-5440-93) and 4 ounce (120 mL) bottles (NDC 0069-5440-97) in packages of 4.

Shake vigorously until product is completely resuspended.

BIBLIOGRAPHY - Available on request.

Distributed by: Pfizer Labs Division of Pfizer Inc, NY, NY 10017. Revised: Nov 2016

See also:
What is the most important information I should know about Calamine (Antipru)?

Do not use this medication if you are allergic to pramoxine.

Before using pramoxine topical, tell your doctor if you are allergic to any drugs or any other anesthetics or "numbing medicines."

See also:
What is the most important information I should know about Diphenhydramine (Antipru)?

Hypersensitivity to Diphenhydramine (Antipru), other structurally related antihistamines, or any component of the formulation; neonates or premature infants; breast-feeding

Additional contraindications:

Parenteral: Use as a local anesthetic

OTC labeling: When used for self-medication, do not use in children <6 years, to make a child sleep, or with any other Diphenhydramine (Antipru)-containing products (including topical products)

See also:
What is the most important information I should know about Hydroxyzine (Antipru)?

Hypersensitivity to Hydroxyzine (Antipru) or any of the excipients of Hydroxyzine (Antipru), to cetirizine, to other piperazine derivatives, to aminophylline, or to ethylenediamine; porphyria; acquired or congenital QT interval prolongation, risk factor to QT interval prolongation including known cardiovascular disease, significant electrolyte imbalance (hypokalemia and hypomagnesemia), family history of sudden cardiac death, significant bradycardia, concomitant use with drugs known to prolong the QT interval and/or induce Torsades de pointes.

Use in pregnancy: Hydroxyzine (Antipru) is contraindicated during pregnancy.

Animal studies have shown reproductive toxicity.

Hydroxyzine (Antipru) crosses the placental barrier leading to higher foetal than maternal concentrations.

To date, no relevant epidemiological data are available relating to exposure to Hydroxyzine (Antipru) during pregnancy.

In neonates whose mothers received Hydroxyzine (Antipru) during late pregnancy and/or labour, the following events were observed immediately or only a few hours after birth: Hypotonia, movement disorders including extrapyramidal disorders, clonic movements, CNS depression, neonatal hypoxic conditions or urinary retention.

Use in lactation: Hydroxyzine (Antipru) is contraindicated during lactation. Breastfeeding should be stopped if Hydroxyzine (Antipru) therapy is needed.

Cetirizine, the principal metabolite of Hydroxyzine (Antipru), is excreted in human milk.

Although no formal studies have been performed on the excretion of Hydroxyzine (Antipru) in human milk, severe adverse effects have been shown in breastfed newborns/infants of Hydroxyzine (Antipru) treated mothers.

Use Calamine (Antipru) lotion as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Shake well before using.
• Apply Calamine (Antipru) lotion as often as necessary. A cotton pledget or soft cloth may be used for easy application.
• Do not apply Calamine (Antipru) lotion over large areas of the body.
• If you miss using a dose of Calamine (Antipru) lotion for 1 or more days, there is no cause for concern. If your doctor recommended that you use it, try to remember your dose every day.

Ask your health care provider any questions you may have about how to use Calamine (Antipru) lotion.

Use Diphenhydramine (Antipru) orally disintegrating strips as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Take Diphenhydramine (Antipru) orally disintegrating strips by mouth with or without food.
• Do not remove the strip from the pouch until you are ready to take Diphenhydramine (Antipru) orally disintegrating strips. Make sure that your hands are dry when you open Diphenhydramine (Antipru) orally disintegrating strips. Remove and place the strip on the tongue. The strip dissolves quickly (and it can be swallowed with saliva). Diphenhydramine (Antipru) orally disintegrating strips may be taken with or without water. Take the strip immediately after opening the pouch. Do not store the strip for future use.
• Use Diphenhydramine (Antipru) orally disintegrating strips exactly as directed on the package, unless instructed differently by your doctor. If you are taking Diphenhydramine (Antipru) orally disintegrating strips without a prescription, follow any warnings and precautions on the label.
• If you miss a dose of Diphenhydramine (Antipru) orally disintegrating strips and you are taking it regularly, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Diphenhydramine (Antipru) orally disintegrating strips.

Use Hydroxyzine (Antipru) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Hydroxyzine (Antipru) is usually given as an injection at your doctor's office, hospital, or clinic. If you will be using Hydroxyzine (Antipru) at home, a health care provider will teach you how to use it. Be sure you understand how to use Hydroxyzine (Antipru). Follow the procedures you are taught when you use a dose. Contact your health care provider if you have any questions.
• Do not use Hydroxyzine (Antipru) if it contains particles, is cloudy or discolored, or if the vial is cracked or damaged.
• Keep this product, as well as syringes and needles, out of the reach of children and pets. Do not reuse needles, syringes, or other materials. Ask your health care provider how to dispose of these materials after use. Follow all local rules for disposal.
• If you miss a dose of Hydroxyzine (Antipru) and you are using it regularly, take it as soon as possible. If it is almost time for you next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Hydroxyzine (Antipru).

This medication is used to treat itching and pain caused by minor burns/cuts/scrapes, sunburn, insect bites, minor skin irritations, or rashes from poison ivy, poison oak, or poison sumac.

Diphenhydramine belongs to a class of drugs known as antihistamines. It works by preventing the effects of a certain natural substance (histamine) that causes itching. Calamine (Antipru) helps to dry the oozing and weeping caused by irritation from poisonous plants.

Use of this medication is not recommended in children younger than 2 years unless directed by the doctor.

How to use Calamine (Antipru) (with diphenhydramine) topical

Use this medication on the skin only. Some products may need to be shaken well before use. Follow all directions on the product package, or use as directed by your doctor. Before applying, clean the affected area with soap and water. Gently pat dry. Apply to the affected area as directed, usually 3 to 4 times a day. Wash hands immediately after use, unless the area being treated includes the hands.

Do not use on large areas of the body or apply more often than directed. Do not use on chickenpox or measles. Do not use with other products that contain diphenhydramine (e.g., allergy medication taken by mouth). Your condition will not clear faster, but side effects may be increased.

Avoid getting the product in your eyes, nose, ears, or mouth. If the medication gets in these areas, rinse the area right away with clean water.

Tell your doctor if your condition persists or worsens after 7 days of treatment. If you think you may have a serious medical problem, seek immediate medical attention.

Diphenhydramine (Antipru) is an antihistamine used to relieve symptoms of allergy, hay fever, and the common cold. These symptoms include rash, itching, watery eyes, itchy eyes/nose/throat, cough, runny nose, and sneezing. It is also used to prevent and treat nausea, vomiting and dizziness caused by motion sickness. Diphenhydramine (Antipru) can also be used to help you relax and fall asleep.

This medication works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. Its drying effects on such symptoms as watery eyes and runny nose are caused by blocking another natural substance made by your body (acetylcholine).

Cough-and-cold products have not been shown to be safe or effective in children younger than 6 years. Therefore, do not use this product to treat cold symptoms in children younger than 6 years unless specifically directed by the doctor. Some products (such as long-acting tablets/capsules) are not recommended for use in children younger than 12 years. Ask your doctor or pharmacist for more details about using your product safely.

These products do not cure or shorten the length of the common cold and may cause serious side effects. To decrease the risk for serious side effects, carefully follow all dosage directions. Do not use this product to make a child sleepy. Do not give other cough-and-cold medication that might contain the same or similar ingredients. Ask the doctor or pharmacist about other ways to relieve cough and cold symptoms (such as drinking enough fluids, using a humidifier or saline nose drops/spray).

OTHER USES: This section contains uses of this drug that are not listed in the approved professional labeling for the drug but that may be prescribed by your health care professional. Use this drug for a condition that is listed in this section only if it has been so prescribed by your health care professional.

Diphenhydramine (Antipru) is also used alone or with other medications to treat shaking (tremor) and muscle stiffness caused by Parkinson's disease. It may also be used to treat side effects of certain psychiatric drugs such as involuntary movements and muscle stiffness (such as EPS). It works by blocking acetylcholine.

How to use Diphenhydramine (Antipru)

Follow all directions on the product package. If your doctor has prescribed this medication, take it as directed. If you are uncertain about any of the information, consult your doctor or pharmacist.

Take the tablet, capsule, or liquid form by mouth with or without food. Measure liquid forms of this medication using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. If you have a single-dose form of this medication (such as a single-use whistle), you do not need to measure the dose.

The rapidly-dissolving tablet or strip should be allowed to dissolve on the tongue and then swallowed, with or without water. The chewable tablets should be chewed thoroughly before being swallowed.

The dosage is based on your age, medical condition, and response to treatment. There are many brands and forms of Diphenhydramine (Antipru) available. Read the dosing instructions carefully for each product because the amount of Diphenhydramine (Antipru) may be different between products. Do not increase your dose or take this medication more often than directed.

To prevent motion sickness, take your dose 30 minutes before starting activity such as travel. To help you sleep, take your dose about 30 minutes before bedtime. If you continue to have difficulty sleeping for longer than 2 weeks, contact your doctor.

Tell your doctor if your condition does not improve or if it worsens.

Hydroxyzine (Antipru) is used for the short-term treatment of nervousness and tension that may occur with certain mental/mood disorders (e.g., anxiety, dementia). It is also used to help manage withdrawal symptoms (e.g., anxiety, agitation) in alcoholics. Other uses include helping to decrease anxiety and nausea before/after surgery or during childbirth or helping certain narcotic pain relievers (e.g., meperidine) work better.

Hydroxyzine (Antipru) belongs to a class of medications called antihistamines. It is thought to work by affecting certain natural substances (acetylcholine, serotonin) in your body or by acting directly on certain parts of the brain. Hydroxyzine (Antipru) also blocks a natural substance that your body makes during an allergic reaction (histamine).

How to use Hydroxyzine (Antipru) intramuscular

This medication is given by injection into a muscle as directed by your doctor. Dosage is based on your age, weight, medical condition, and response to treatment.

If you are giving this medication to yourself at home, learn all preparation and usage instructions from your health care professional. Before using, check this product visually for particles or discoloration. If either is present, do not use the liquid. Learn how to store and discard medical supplies safely.

See also:
What other drugs will affect Calamine (Antipru)?

If you are using this product under your doctor's direction, your doctor or pharmacist may already be aware of possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor or pharmacist first.

Before using this product, tell your doctor or pharmacist if you use any of the following products: other skin products applied to the affected area.

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist.

See also:
What other drugs will affect Diphenhydramine (Antipru)?

Most reports of clinically significant drug interactions occurring with the barbiturates have involved phenobarbital

1. Anticoagulants: Diphenhydramine (Antipru) lowers the plasma levels of dicumarol (name previously used: bishydorxycoumarin) and causes a decrease in anticoagulant activity as measured by the prothrombin time. Diphenhydramine (Antipru) can induce hepatic microsomal enzymes resulting in increased metabolism and decreased anticoagulant response of oral anticoagulants (e.g., warfarin, acenocournarol, dicumarol, and phenprocoumon). Patients stabilized on anticoagulant therapy may require dosage adjustments if phenobarbital is added to or withdrawn from their dosage regimen

2. Corticosteroids: Diphenhydramine (Antipru) appears to enhance the metabolism of exogenous corticosteroids probably through the induction of hepatic microsomal enzymes. Patients stabilized on corticosteroid therapy may require dosage adjustments if phenobarbital is added to or withdrawn from their dosage regimen.

3. Griseofulvin: Diphenhydramine (Antipru) appears to interfere with the absorption of orally administered griseofulvin, thus decreasing its blood level. The effect of the resultant decreased blood levels of griseofulvin on therapeutic response has not been established. However, it would be preferable to avoid concomitant administration of these drugs.

4. Doxycycline: Diphenhydramine (Antipru) has been shown to shorten the half- life of doxycycline for as long as 2 weeks after barbiturate therapy is discontinued. This mechanism is probably through the induction of hepatic microsomal enzymes that metabolize the antibiotic. If phenobarbital and doxycycline are administered concurrently, the clinical response to doxycycline should be monitored closely

5. Phenytoin, sodium valproate, valproic acid: The effect of phenobarbital on the metabolism of phenytoin appears to be variable. Some investigators report an accelerating effect, while others report no effect. Because the effect of phenobarbital on the metabolism of phenytoin is not predictable, phenytoin and phenobarbital blood levels should be monitored more frequently if these drugs are given concurrently. Sodium valproate and valproic acid appear to decrease phenobarbital metabolism; therefore, phenobarbital blood levels should be monitored and appropriate dosage adjustments made as indicated.

6. Central nervous system depressants: The concomitant use of other central nervous system depressants including other sedatives or hypnotics, antihistamines, tranquilizers, or alcohol, may produce additive depressant effects

7. Monoamine oxidase inhibitors (MAOIs): MAOIs prolong the effects of phenobarbital probably because metabolism of the phenobarbital is inhibited.

8. Estradiol, estrone, progesterone and other steroidal hormones: Pretreatment with or concurrent administration of phenobarbital may decrease the effect of estradiol by increasing its metabolism. There have been reports of patients treated with antiepileptic drugs (e.g., phenobarbital) who became pregnant while taking oral contraceptives. An alternate contraceptive method might be suggested to women taking phenobarbital.

See also:
What other drugs will affect Hydroxyzine (Antipru)?

Central Nervous System Depressants: Patients should be informed that Hydroxyzine (Antipru) may potentiate the effects of barbiturates, other CNS depressants or drugs having anticholinergic properties.

Alcohol: Alcohol also potentiates the effects of Hydroxyzine (Antipru).

Betahistine and Anticholinesterase Drugs: Hydroxyzine (Antipru) antagonizes the effects of betahistine and anticholinesterase drugs.

Tests Results: The treatment should be stopped at least 5 days before allergy testing or methacholine bronchial challenge, to avoid effects on the test results.

Monoamine Oxidase Inhibitors: Simultaneous administration of Hydroxyzine (Antipru) with MAOIs should be avoided.

Epinephrine: Hydroxyzine (Antipru) counteracts the epinephrine pressor action.

Phenytoin: In rats, Hydroxyzine (Antipru) antagonized the anticonvulsant action of phenytoin.

Cimetidine: Cimetidine 600 mg twice daily has been shown to increase the serum concentrations of Hydroxyzine (Antipru) by 36% and to decrease peak concentrations of the metabolite cetirizine by 20%.

CYP2D6 Substrates: Hydroxyzine (Antipru) is an inhibitor of cytochrome P-450 2D6 (Ki: 3.9 micrometer; 1.7 mcg/mL) and may cause at high doses drug-drug interactions with CYP2D6 substrates.

Effect on Other Drug Metabolism: Hydroxyzine (Antipru) has no inhibitory effect at 100 micrometer on UDP-glucuronyl transferase isoforms 1A1 and 1A6 in human liver microsomes. It inhibits cytochrome P-450 2C9/C10, 2C19 and 3A4 isoforms at concentrations (IC₅₀: 19-140 micrometer; 7-52 mcg/mL) well above peak plasma concentrations. The metabolite cetirizine at 100 micrometer has no inhibitory effect on human liver cytochrome P-450 (1A2, 2A6, 2C9/C10, 2C19, 2D6, 2E1 and 3A4) and UDP-glucuronyl transferase isoforms. Therefore, Hydroxyzine (Antipru) is unlikely to impair the metabolism of drugs which are substrates for these enzymes.

Potent Inhibitors of Liver Enzymes: As Hydroxyzine (Antipru) is metabolized in the liver, an increase in Hydroxyzine (Antipru) blood concentrations may be expected when Hydroxyzine (Antipru) is co-administered with other drugs known to be potent inhibitors of liver enzymes.

Potentially Arrhythmogenic Drugs: Co-administration of Hydroxyzine (Antipru) with a potentially arrhythmogenic drug may increase the risk of QT prolongation and Torsades de pointes.

See also:
What are the possible side effects of Calamine (Antipru)?

Mild stinging, redness, swelling, or dry/flaky skin may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

If your doctor has directed you to use this medication, remember that he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

See also:
What are the possible side effects of Diphenhydramine (Antipru)?

Applies to acetaminophen / Diphenhydramine (Antipru): tablets

Other dosage forms:

• capsules, tablets

Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; diarrhea; dizziness; drowsiness; dry mouth, nose, or throat; excitability; headache; loss of appetite; nausea; nervousness or anxiety; upset stomach; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur while taking acetaminophen / Diphenhydramine (Antipru):

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); dark urine or pale stools; difficulty urinating or inability to urinate; fast or irregular heartbeat; hallucinations; seizures; severe dizziness, drowsiness, lightheadedness, or headache; severe or persistent loss of appetite; stomach pain; tremor; trouble sleeping; unusual fatigue; vision changes; yellowing of the skin or eyes.

See also:
What are the possible side effects of Hydroxyzine (Antipru)?

Adverse effects are mainly related to CNS depressant or paradoxical CNS stimulation effects, to anticholinergic activity, or to hypersensitivity reactions.

Adverse reactions are ranked under headings of frequency using the following convention: Very common ≥1/10, common ≥1/100 to <1/10, uncommon ≥1/1,000 to <1/100, rare ≥1/10,000 to <1/1,000, very rare <1/10,000, not known (cannot be estimated from the available data).

Clinical Trial Data: The following adverse effects were reported in placebo-controlled clinical trials for Hydroxyzine (Antipru) and including 735 subjects exposed to Hydroxyzine (Antipru) up to 50 mg daily.

Nervous System Disorders: Very Common: Somnolence. Common: Headache. Uncommon: Dizziness, insomnia, attention disturbance.

Gastrointestinal Disorders: Common: Dry mouth. Uncommon: Constipation, nausea.

General Disorders and Administration Site Conditions: Common: Fatigue. Uncommon: Asthenia.

Post-Marketing Data: Immune System Disorders: Not Known: Hypersensitivity, anaphylactic shock.

Psychiatric Disorders: Not Known: Agitation, confusion, disorientation, hallucination.

Nervous System Disorders: Not Known: Sedation, tremor, convulsions, dyskinesia.

Eye Disorders: Not Known: Accommodation disorder, blurred vision.

Cardiac Disorders: Not Known: Tachycardia, prolonged electrocardiogram QT, Torsades de pointes.

Vascular Disorders: Not Known: Hypotension.

Respiratory, Thoracic and Mediastinal Disorders: Not Known: Bronchospasm.

Gastrointestinal Disorders: Not Known: Vomiting.

Hepatobiliary Disorders: Not Known: Abnormal liver function tests.

Skin and Subcutaneous Tissue Disorders: Not Known: Pruritus, erythematous rash, maculopapular rash, urticaria, dermatitis, angioneurotic edema, hyperhidrosis, fixed drug eruption, acute generalized exanthematous pustulosis, erythema multiforme, Stevens-Johnson syndrome.

Renal and Urinary Disorders: Not Known: Urinary retention.

General Disorders and Administration Site Conditions: Not Known: Malaise, pyrexia.

The following adverse reactions have been observed with cetirizine, the principal metabolite of Hydroxyzine (Antipru): Thrombocytopenia, aggression, depression, tic, dystonia, paresthesia, oculogyric crisis, diarrhea, dysuria, enuresis, asthenia, edema, increased weight and could potentially occur with Hydroxyzine (Antipru).