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The administration of hydroxyzine in large amounts by ingestion or intramuscular administration during the onset of pregnancy can cause fetal abnormalities—when administered to pregnant rats, mice and rabbits, hydroxyzine caused abnormalities with doses significantly above that of the human therapeutic range.[5] In terms of humans, a significant dose has not yet been established in studies, and by default, the FDA has introduced contraindication guidelines in regard to hydroxyzine.[5] Similarly, those at risk from, or showing previous signs of hypersensitivity are also contraindicated.[5]
Other contraindications include the administration of hydroxyzine alongside depressants and other compounds which affect the central nervous system, such as narcotics, non-narcotic analgesics and barbiturates, as well as alcohol,[5] and if absolutely necessary, should only administered concomitantly in small doses[5] as any pre-existing grogginess from these substances may be enhanced. If administered in small doses with other substances, such as mentioned, then patients should refrain from using dangerous machinery, motor vehicles or any other practice requiring absolute concentration, in accordance with safety law.[5]
Studies have also been conducted which show that long-term prescription of hydroxyzine can lead to tardive dyskinesia after years of use, but has also been reported after periods of 7.5 months showed effects related to dyskinesia,[10] such as continual head rolling, lip licking and other forms of athetoid movement. In certain cases, elderly patients’ previous interactions with phenothiazine derivatives or pre-existing neuroleptic treatment may have had some contribution towards dyskinesia at the administration of hydroxyzine due to hypersensitivity caused due to the prolonged treatment,[10] and therefore some contraindication is given to the short-term administration of hydroxyzine to those with previous phenothiazine use.[10]
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