Hydroxyzine reduces activity in the central nervous system. It also acts as an antihistamine that reduces the natural chemical histamine in the body. Histamine can produce symptoms of sneezing and runny nose, or hives on the skin.

Hydroxyzine is used as a sedative to treat anxiety and tension. It is also used together with other medications given for anesthesia. Hydroxyzine may also be used to control nausea and vomiting.

Hydroxyzine is also used to treat allergic skin reactions such as hives or contact dermatitis.

Hydroxyzine may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Atarax (Hydroxyzine)?

You should not use this medication if you are allergic to hydroxyzine, or if you are pregnant.

Before you take hydroxyzine, tell your doctor if you have a seizure disorder, liver disease, or kidney disease.

Hydroxyzine can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert. Stop using hydroxyzine and call your doctor at once if you have a serious side effect such as tremors, confusion, seizures, or restless muscle movements in your eyes, tongue, jaw, or neck. Avoid drinking alcohol. It can increase some of the side effects of hydroxyzine.

What should I discuss with my healthcare provider before taking Atarax (Hydroxyzine)?

You should not use this medication if you are allergic to hydroxyzine, or if you are pregnant.

If you have certain conditions, you may need a dose adjustment or special tests to safely use this medication. Before you take hydroxyzine, tell your doctor if you have:

• epilepsy or other seizure disorder;
• asthma, emphysema, or other breathing problem;
• glaucoma;
• heart disease or high blood pressure;
• stomach ulcer, blockage in your stomach or intestines;
• thyroid disorder;
• enlarged prostate or problems with urination;
• liver disease; or
• kidney disease.

FDA pregnancy category D. Do not use hydroxyzine without telling your doctor if you are pregnant. It could harm the unborn baby. Use effective birth control, and tell your doctor if you become pregnant during treatment. It is not known whether hydroxyzine passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby. Older adults may be more likely to have side effects from this medication.

How should I take Atarax (Hydroxyzine)?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Take this medicine with a full glass of water.

Measure liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

Store hydroxyzine at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, wait until then to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include extreme drowsiness, nausea, vomiting, feeling like you might pass out.

Atarax (Hydroxyzine) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Stop using hydroxyzine and call your doctor at once if you have a serious side effect such as:

• restless muscle movements in your eyes, tongue, jaw, or neck;
• tremor (uncontrolled shaking);
• confusion; or
• seizure (convulsions).

Less serious side effects may include:

• dizziness, drowsiness;
• blurred vision, dry mouth; or
• headache.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Atarax (Hydroxyzine)?

Before using hydroxyzine, tell your doctor if you regularly use other medicines that make you sleepy (such as cold or allergy medicine, sedatives, narcotic pain medicine, sleeping pills, muscle relaxers, and medicine for seizures, depression, or anxiety). They can add to sleepiness caused by hydroxyzine.

This list is not complete and there may be other drugs that can interact with hydroxyzine. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

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Nortriptyline is in a group of drugs called tricyclic antidepressants. Nortriptyline affects chemicals in the brain that may become unbalanced.

Nortriptyline is used to treat symptoms of depression.

Nortriptyline may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about Pamelor (Nortriptyline)?

Do not use nortriptyline if you have recently had a heart attack, or if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

What should I discuss with my healthcare provider before taking Pamelor (Nortriptyline)?

Do not use this medication if you are allergic to nortriptyline, or if you have recently had a heart attack. Do not use nortriptyline if you have used an MAO inhibitor such as isocarboxazid (Marplan), phenelzine (Nardil), rasagiline (Azilect), selegiline (Eldepryl, Emsam), or tranylcypromine (Parnate) within the past 14 days. Serious, life-threatening side effects can occur if you take nortriptyline before the MAO inhibitor has cleared from your body.

Before taking nortriptyline, tell your doctor if you are allergic to any drugs, or if you have:

• heart disease;
• a history of heart attack, stroke, or seizures;
• bipolar disorder (manic-depression);
• schizophrenia or other mental illness;
• diabetes (nortriptyline may raise or lower blood sugar);
• overactive thyroid;
• glaucoma; or
• problems with urination.

If you have any of these conditions, you may need a dose adjustment or special tests to safely take nortriptyline.

You may have thoughts about suicide when you first start taking an antidepressant, especially if you are younger than 24 years old. Tell your doctor if you have worsening symptoms of depression or suicidal thoughts during the first several weeks of treatment, or whenever your dose is changed.

Your family or other caregivers should also be alert to changes in your mood or symptoms. Your doctor will need to check you at regular visits for at least the first 12 weeks of treatment.

This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether nortriptyline passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

Older adults may be more likely to have side effects from this medication.

Do not give this medication to anyone under 18 years old without the advice of a doctor.

How should I take Pamelor (Nortriptyline)?

Take this medication exactly as it was prescribed for you. Do not take the medication in larger amounts, or take it for longer than recommended by your doctor. Your doctor may occasionally change your dose to make sure you get the best results from this medication. Follow the directions on your prescription label.

If you need to have any type of surgery, tell the surgeon ahead of time that you are taking nortriptyline. You may need to stop using the medicine for a short time.

Do not stop using nortriptyline without first talking to your doctor. You may need to use less and less before you stop the medication completely. Stopping this medication suddenly could cause you to have unpleasant side effects. It may take a few weeks of using this medicine before your symptoms improve. For best results, keep using the medication as directed. Talk with your doctor if your symptoms do not improve during treatment with nortriptyline. Store nortriptyline at room temperature away from moisture and heat.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of nortriptyline can be fatal.

Overdose symptoms may include extreme drowsiness, confusion, agitation, hallucinations, blurred vision, vomiting, muscle stiffness, feeling hot or cold, fainting, seizure (convulsions), or coma.

Pamelor (Nortriptyline) side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any new or worsening symptoms such as: mood or behavior changes, anxiety, panic attacks, trouble sleeping, or if you feel impulsive, irritable, agitated, hostile, aggressive, restless, hyperactive (mentally or physically), more depressed, or have thoughts about suicide or hurting yourself.

Call your doctor at once if you have any of these serious side effects:

• fast, pounding, or uneven heart rate;
• chest pain or heavy feeling, pain spreading to the arm or shoulder, nausea, sweating, general ill feeling;
• sudden numbness or weakness, especially on one side of the body;
• sudden headache, confusion, problems with vision, speech, or balance;
• confusion, hallucinations, or seizure (convulsions);
• easy bruising or bleeding, unusual weakness;
• restless muscle movements in your eyes, tongue, jaw, or neck;
• tremors;
• extreme thirst with headache, nausea, vomiting, and weakness;
• feeling light-headed or fainting; or
• urinating less than usual or not at all.

Less serious side effects may include:

• nausea, vomiting, stomach pain, loss of appetite;
• constipation or diarrhea;
• weight changes;
• dry mouth, unpleasant taste;
• weakness, lack of coordination;
• numbness or tingly feeling;
• blurred vision, headache, ringing in your ears;
• mild skin rash;
• breast swelling (in men or women); or
• increased sweating.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

What other drugs will affect Pamelor (Nortriptyline)?

Before taking nortriptyline, tell your doctor if you have used an “SSRI” antidepressant in the past 5 weeks, such as citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), paroxetine (Paxil), or sertraline (Zoloft).

Before taking nortriptyline, tell your doctor if you are currently using any of the following drugs:

• cimetidine (Tagamet);
• guanethidine (Ismelin);
• reserpine; or
• heart rhythm medications such as flecainide (Tambocor), propafenone (Rhythmol), or quinidine (Cardioquin, Quinidex, Quinaglute).

This list is not complete and there are many other medicines that can interact with nortriptyline. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

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