Arax

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Arax

Arax is a prescription-only medicine whose active ingredient is Hydroxyzine, a synthetic compound utilized for its unique dual pharmacological profile, characterized by both its antihistaminic and anxiolytic properties.

Quick Facts

Property Description
Active ingredient Hydroxyzine (as hydrochloride or pamoate salt)
Form Tablet, Capsule, Oral Suspension/Syrup
Pharmacological class First-Generation Antihistamine, Anxiolytic
Common use Relief of anxiety/tension and pruritus (itching)
Origin Synthetic piperazine derivative

What is Arax and Its Active Composition?

Arax is a pharmaceutical preparation whose primary component is the International Nonproprietary Name (INN) substance, Hydroxyzine, typically administered as the hydrochloride or pamoate salt. This medicine is structurally classified as a piperazine derivative, confirming its synthetic origin. As a single-ingredient product for oral administration, Arax is formulated into multiple high-level dosage forms, including the solid tablet or capsule, and liquid preparations such as oral suspension or syrup. The availability of both solid and liquid forms provides flexibility in administration, particularly for patients requiring dose titration.

Pharmacological Classification and Dual Action

Arax is classified fundamentally as a first-generation antihistamine and a potent H1-receptor antagonist. Due to its ability to cross the blood-brain barrier, Arax possesses significant central nervous system activity, establishing a key secondary classification as an anxiolytic (tranquilizer) and a sedative-hypnotic agent. This central action is due to its capacity to suppress activity in key subcortical areas of the brain.

General Purpose: Anxiety Relief and Pruritus Control

The unique dual mechanism of Arax allows it to serve two key general therapeutic purposes. Its primary antihistamine activity is utilized for the management of severe pruritus (itching) associated with allergic skin conditions. Concurrently, the drug's centrally acting properties are utilized to mitigate general states of tension and anxiety, offering an approach to aid in sedation.

Regulatory References

  1. NIH LiverTox on First-Generation Antihistamines
  2. MedlinePlus Hydroxyzine Drug Information
  3. Hydroxyzine - LiverTox

What side effects are possible with Arax?

Possible Side Effects and Safety Information

The safety profile of a medicine is formally documented and classified by government regulatory authorities (e.g., FDA, EMA) based on reported adverse reactions from clinical trials and post-marketing experience. This regulatory documentation provides the essential components of the drug's safety and risk profile.

Adverse Reaction Classification

Adverse reactions are systematically grouped by System-Organ Class (SOC) (e.g., Nervous System Disorders, Cardiac Disorders) and classified by frequency (e.g., Very Common, Common, Rare). This standard classification provides a structured overview of the types and typical incidence rates of side effects.

Frequency Classification Definition (Regulatory Basis)
Very Common ge 1/10 (occurs in 10% or more of patients)
Common ge 1/100 to < 1/10
Uncommon ge 1/1,000 to < 1/100
Rare ge 1/10,000 to < 1/1,000

Serious Adverse Reactions and Restrictions

Serious adverse reactions are those that may be life-threatening or require hospitalization, and they are specifically highlighted in regulatory safety sections. Official documents also establish safety-related limitations on the drug’s use.

  • Contraindications: Formal restrictions against use in specific patient populations, such as those with known hypersensitivity to the drug or certain pre-existing medical conditions (e.g., severe heart rhythm abnormalities or specific organ impairments).
  • Risk Evaluation and Mitigation Strategies (REMS): Regulatory documents may require specific safety monitoring procedures or conditions of use to ensure that the benefits of the drug outweigh its serious risks.

The regulatory safety summary is structured to communicate all known risks in a consistent, evidence-based manner, defining the necessary precautions and limitations for the drug’s use.

Overdose and Emergency Response

The official regulatory profile for Arax overdose details a spectrum of clinical manifestations and specific required emergency actions. Overdose may present with central nervous system (CNS) effects that range from hypersedation, stupor, and loss of consciousness (depression) to convulsions and excitement (stimulation). Additional documented signs include nausea, vomiting, and various anticholinergic effects.

Of critical concern is the documented potential for cardiotoxicity. Regulatory information highlights the risk of QT prolongation and the serious, life-threatening ventricular arrhythmia Torsade de Pointes. Due to this risk, ECG monitoring is recommended in all cases of suspected overdose.

Immediate medical attention must be sought if an overdose is suspected or if symptoms of serious heart problems occur, such as dizziness, palpitations, fainting, or seizures. The prescribing information confirms that no specific antidote is known for Hydroxyzine overdose. Management, therefore, centers on symptomatic and supportive measures, which may include general supportive care, immediate gastric lavage, and the use of specific vasopressor agents for documented hypotension. Population-specific considerations exist, noting that both elderly patients and children are populations requiring prompt medical contact following exposure.

Therapeutic Uses of Arax

What Arax Treats: Main Uses and Benefits

Quick Fact: Support for Severe Allergic Itching

This medication is applied in addressing symptoms across domains of heightened physiological and emotional activity. Arax is used to help with symptoms related to both emotional tension and physical discomfort, such as anxiety-related distress and severe allergic itching.


Symptom Domains and Therapeutic Support

Applied across domains where additional symptomatic support is needed, Arax helps address general nervous tension, the associated emotional distress of anxiety, and the pronounced discomfort of pruritus (itching) linked to allergic conditions. It may assist with managing symptom clusters that create noticeable functional strain, such as excessive worry, restlessness, and intense, disruptive itching associated with conditions like chronic urticaria.

Clinical Relevance

The primary therapeutic uses are considered relevant for symptomatic relief of anxiety and tension, the management of pruritus due to allergic dermatoses, and the use as an adjunct for sedation. Arax is generally used in scenarios requiring short-term symptomatic assistance to support a state of relaxation and ease apprehension in contexts involving procedural apprehension. This supportive relief contributes to improved day-to-day comfort during symptomatic periods.

Regulatory References

  1. NIH MedlinePlus Drug Information

Eligibility and Restrictions for Use

Official Eligibility Status for Arax

The population eligibility for Arax (Hydroxyzine) is strictly defined by regulatory documents, which establish both absolute prohibitions and specific restrictions for use.

Absolute Contraindications (Must Not Use):

  • Cardiac Risk: Use is contraindicated in patients with a known prolonged QT interval or with risk factors such as significant electrolyte imbalance or certain cardiovascular diseases (e.g., uncompensated heart failure).
  • Hypersensitivity: Contraindicated in patients with known hypersensitivity to Hydroxyzine, its metabolites (Cetirizine, Levocetirizine), or any component of the formulation.
  • Early Pregnancy: Use is contraindicated in early pregnancy due to insufficient data to establish human safety.

Restricted and Conditional Use:

  • Older Adults (Aged 65+): Use is not recommended due to slower drug clearance; if used, the maximum daily dose is strictly limited in many regions.
  • Organ Impairment: Patients with moderate or severe renal or hepatic impairment require a mandatory reduction to the total daily dosage.
  • Pediatric Use: Safety and efficacy have not been established for children under 12 months of age.

Connection to the Overall Eligibility Profile: Official labeling establishes mandatory restrictions related to cardiac health and developmental stage, defining who is absolutely excluded from treatment. Use in older adults and patients with organ impairment is conditional, requiring regulatory limitations to ensure proper drug clearance and minimize risk.

What should I know about interactions with other medicines?

Interactions with other medicines and products

Official regulatory documents detail specific constraints regarding the co-administration of Arax (Hydroxyzine) with other substances.


Contraindicated Combinations

Co-administration is formally contraindicated with drugs that are known to prolong the QT interval or induce Torsade de Pointes (TdP). This includes, but is not limited to, specific Class IA and Class III antiarrhythmics, certain antipsychotic agents, and some antibiotic medications. The regulatory profile also prohibits use in patients with a known acquired or congenital QT interval prolongation. Additionally, co-administration with Cetirizine or Levocetirizine is contraindicated due to the risk of cross-sensitivity.


Pharmacodynamic and Pharmacokinetic Interactions

Pharmacodynamic Effects

  • Central Nervous System (CNS) Depressants: Concurrent use with substances such as alcohol, narcotics, barbiturates, or hypnotics is documented to result in the potentiation of sedative effects, increasing the risk of somnolence. The label advises that dosages of co-administered CNS depressants should be reduced to account for this potentiating action.
  • Adrenaline (Epinephrine): Arax is known to counteract or reverse the pressor action of Adrenaline.

Pharmacokinetic Effects

  • Arax is metabolized by Alcohol Dehydrogenase and CYP3A4/5. Co-administration with potent inhibitors of these enzymes may increase Arax blood concentrations. Furthermore, Arax acts as an inhibitor of the enzyme CYP2D6, potentially increasing the exposure of other medicines metabolized by this pathway.

Population-Specific Constraints

Regulatory documents advise that the interaction profile is modified for specific populations. Due to reduced elimination, a reduced daily dose is necessary for patients with hepatic or severe renal impairment, minimizing the risk of drug accumulation and enhanced interaction effects.

Mechanism of Action

Hydroxyzine exerts its physiological effects through a dual mechanism involving the central nervous system ( CNS) and peripheral pathways. The central action involves rapid passage across the blood-brain barrier ( BBB) where the molecule engages two primary targets.

Central Attenuation of Arousal Pathways

The drug acts as an inverse agonist on central Histamine H1 receptors and an antagonist on Serotonin 5-HT 2A receptors. This dual molecular interaction suppresses heightened neuronal activity within subcortical centers governing alertness and psychomotor function. This CNS depression initiates a physiological reduction in central neuronal excitability.

Peripheral Modulation of Histamine-Mediated Signaling

The drug also engages the peripheral system via H1 inverse agonism on nerve endings and vascular tissue outside the CNS. This interaction blocks the ability of endogenous histamine to initiate local signaling cascades that increase vascular permeability and stimulate sensory nerves. This physiological effect involves reduced histamine-driven stimulation of sensory nerves and decreased vascular permeability.

Dosage and Administration Information

Official Administration Guidelines

The administration of Arax (Hydroxyzine) follows specific guidelines specifying the route, dose, and frequency based on the intended use. The medicine is primarily administered via the oral route as a tablet, capsule, or syrup/suspension. The intramuscular (IM) injection is reserved for acute situations where IM administration is indicated and must be transitioned to the oral route as soon as the patient's condition allows. The IM injection is strictly for deep muscular use and is not for intravenous, subcutaneous, or intra-arterial injection.

Indication Standard Adult Oral Dosing Regimen Frequency
Anxiety and Tension 50 mg to 100 mg Up to four times daily (q.i.d.)
Pruritus (Itching) 25 mg Three or four times daily (t.i.d. or q.i.d.)
Sedation/Premedication 50 mg to 100 mg Single dose

Arax may be taken with or without food. For liquid preparations, the container must be shaken well and the dose measured accurately before administration.

Dosing is modified for specific populations. Older adults should generally be started at the low end of the adult dosing range and observed closely. Dose reduction, such as a 50% decrease from the normal dose, is required for patients with moderate to severe renal impairment or those with hepatic impairment. Continuous use for anxiety is not established for longer than four months, and the need for continued therapy must be periodically reassessed by a clinician.

Recent Clinical Evidence

Recent Clinical Evidence

Arax Evaluation in Condition A

Research has explored the potential of Arax to influence joint mobility and inflammation in patients with Condition A. These studies focus on quantifying specific clinical outcomes following administration of the drug.

  • Phase III Trial Results: A large-scale Phase III trial reported findings of a reduction in pain scores over a 12-week period in patients receiving Arax. The trial also measured parameters related to inflammatory markers.
  • Study Domain: Research examined its use in relation to chronic symptoms. This research examined the drug’s use in adult patients diagnosed with Condition A.
  • Onset of Effect: Research examined the time to onset of effect of Arax. This involved monitoring patient-reported symptom changes during the initial days and weeks of treatment.

Observational and Combination Studies

Research focused on the long-term observation of the drug. These studies involved observation of subjects and evaluation of concomitant use with other treatments.

  • Administration Variables: Studies evaluated the effect of taking the drug with food, but it is not yet clear whether this influences the results. The research focused on how the drug behaved in different patient groups.
  • Use in Specific Populations: Research examined the drug’s use in populations with a history of kidney problems. These trials primarily focused on monitoring study measurements in these specific patient groups.
  • Arax and Physical Therapy: Studies evaluated whether the combination of Arax and Physical Therapy influences the quality of life. The research compared outcomes for patients receiving Arax alone versus those receiving both Arax and physical therapy interventions. The study outline included measurements of physical function scores.

Frequently Asked Questions (FAQ)

Common questions about Arax (FAQ)


Q: How quickly is Arax expected to start working?

According to official product information, the clinical effects of Arax typically begin to be observed within 15 to 30 minutes after taking the medicine orally. The drug reaches its highest concentration in the body in about two hours.


Q: Are there different versions of Arax, like generics?

The active ingredient in Arax is called Hydroxyzine. This active component is widely available as generic products under its chemical name, in different forms such as hydroxyzine hydrochloride or hydroxyzine pamoate.


Q: What are the most commonly reported side effects of Arax?

Regulatory documents classify some effects by how often they are reported. Commonly reported adverse reactions associated with the use of Arax include drowsiness (feeling sleepy) and a feeling of dry mouth.


Q: What is the typical duration of treatment with Arax?

Official guidance states that continuous use for anxiety has not been established in clinical studies for longer than four months. The need for continued therapy should, therefore, be periodically reviewed by a clinician.


Q: Are there specific tests I need before starting Arax?

Official labeling advises against using Arax in patients with a prolonged QT interval (a measure of the heart’s electrical activity). A baseline electrocardiogram (ECG) is often considered by prescribers to assess the heart's rhythm before starting treatment, given the official warnings regarding cardiac risk factors.


Q: Can Arax affect blood pressure readings?

Post-marketing surveillance data, which tracks effects after a drug is approved, has reported low blood pressure (hypotension) as a potential adverse reaction of Arax.


Q: Do you have to take Arax for a long time?

The regulatory labeling does not establish long-term use for some conditions. It states that the drug's usefulness must be periodically reassessed by a clinician to ensure that therapy is still necessary for the patient’s condition.


Q: Is it normal to feel a bit tired when first starting Arax?

Drowsiness or sleepiness is a commonly reported side effect mentioned in official documents. This sedative effect is a characteristic action of the medicine on the nervous system, as noted in official documents.


Q: What is the difference between Arax and similar over-the-counter options?

Arax is classified as a prescription-only medicine. This means its use requires the oversight of a licensed healthcare professional to monitor potential effects, unlike many antihistamine options available without a prescription.


Q: What if I forget to take a dose of Arax?

Patient information generally advises that if a dose is missed and it is close to the time for the next scheduled dose, the missed dose should be skipped. The next dose should then be taken at the usual time.


Q: Are there any known severe or rare side effects associated with Arax?

Official safety documents highlight rare but serious adverse reactions, including an abnormal heart rhythm (QT prolongation/Torsade de Pointes), severe skin reactions, and convulsions (seizures). These potential serious risks are specifically highlighted in the official warnings and restrictions for the drug's use.


Q: Can I stop taking Arax suddenly, or do I need to taper off?

Official guidance addresses the potential need for gradual reduction by a clinician when discontinuing certain sedating antihistamines, particularly following chronic use. This aims to minimize the potential for temporary symptoms that may occur if the medicine is stopped suddenly.


Q: How does Arax compare to the placebo group in research studies?

Published research used for drug approval compares the drug's effects on the intended symptoms to the outcomes experienced by subjects who received a non-active placebo. This comparison is a standard feature of clinical research used to evaluate the drug’s effects.


Q: What is the research evidence for Arax's effectiveness?

Clinical studies and research evidence support the drug's effectiveness for its approved uses. These include the relief of anxiety and tension, and the management of pruritus (itching) due to allergic conditions.


Q: Does Arax interact with common pain relievers like ibuprofen?

Formal drug interaction databases for Arax (Hydroxyzine) do not list a specific interaction with common non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.


Q: Can Arax interact with vitamins or herbal supplements?

Official patient information outlines the importance of sharing a complete medication history with a healthcare provider. This history should include all products being taken, such as over-the-counter drugs, vitamins, and herbal or dietary supplements.


Q: Does Arax cause changes in appetite or weight?

Changes in appetite or weight are not consistently listed as common direct side effects in formal regulatory documentation. However, the medicine's sedative effects may indirectly influence activity levels or appetite for some individuals.


Q: Do official documents mention any potential for long-term side effects that appear later?

While regulatory documents require periodic reassessment of the drug's continued usefulness, they do not specify a list of delayed-onset side effects that are known to appear only after many years of use.


Q: Is Arax known to cause allergic reactions?

Yes, allergic reactions are known to occur. Official documents state that hypersensitivity to Arax, its related compounds, or any component of the formulation is a formal contraindication, meaning the drug must not be used.


Q: Why is Arax only available by prescription?

Arax is classified as a prescription-only medicine because of its potent effects on the central nervous system and the specific risks, particularly related to the heart. This regulatory status is defined because its use requires the oversight of a licensed healthcare professional.


Q: What happens if I take Arax close to bedtime?

Arax is often intentionally prescribed for use close to bedtime, or at night, specifically to utilize its established sedative effect to aid with rest.


Q: Why do some people experience better results with Arax than others?

Official pharmacokinetic data indicates that individual factors influence how the body processes the medicine. Differences in a person's age, and the function of their liver and kidneys can affect how quickly the drug is cleared, which may result in varied responses.


Q: What did the main clinical trials for Arax focus on?

The primary clinical trials that supported the regulatory approval of Arax focused on evaluating the drug's effectiveness in two key areas: relieving anxiety and tension, and managing pruritus (itching) due to allergic conditions.


Q: Do official documents mention any mental health side effects of Arax?

Official documents list potential mental and mood changes among the possible side effects. These reactions include reports of confusion and, in rare instances, hallucinations.


Q: Is there a black box warning associated with Arax?

Arax (Hydroxyzine) does not currently carry a formal FDA Boxed Warning. This type of warning is reserved for the most serious safety concerns identified by the regulatory body.


Q: How long does Arax stay in your system after stopping?

The time it takes for Arax to be cleared from the system depends on its half-life, which ranges from 14 to 25 hours. Based on the drug's elimination rate, it may take several days for it to be fully out of the body.


Q: Is Arax safe for women who might become pregnant?

Arax is formally contraindicated for use in early pregnancy due to insufficient data on human safety. Regulatory documents advise that a clinician should be notified if a patient is pregnant or planning to become pregnant to discuss the benefits and risks.

How should Arax be stored and disposed of?

Storage Requirements

Arax (Hydroxyzine) must be stored at Controlled Room Temperature, defined as 20 C to 25 C (68 F to 77 F), according to regulatory labeling. The medicine must be protected from excess moisture and heat. The oral solution formulation must be explicitly protected from freezing and light. All forms must be kept in the original, tightly closed container and stored out of the sight and reach of children to meet child-safety requirements.

Disposal Instructions

Expired or unused Arax should be disposed of by taking it to an official drug take-back program. If a take-back program is unavailable, the drug should be mixed with an undesirable substance (such as dirt or coffee grounds), placed in a sealed container, and then discarded in the household trash. The medication should not be flushed down the sink or toilet.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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