Drug interactions
Asenapine transdermal + Hydroxyzine
Severity: Major
Asenapine transdermal and Hydroxyzine: major interaction.
Last updated Sources: Health Canada product monograph
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Hydroxyzine and asenapine both have QT-prolonging potential, so combined use may increase the likelihood of torsades de pointes. Additive sedation is also possible.
What this interaction means in plain words
Asenapine transdermal and Hydroxyzine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Why it happens
Additive inhibition of cardiac repolarizing potassium currents causing QTc prolongation.
What to do
Prefer an alternative to hydroxyzine when asenapine is used. If both are required, check a baseline ECG and electrolytes and monitor the QTc after starting.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
Other interactions of Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Asenapine transdermal with Hydroxyzine?
MediHelp rates the interaction as major. Asenapine transdermal and Hydroxyzine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Hydroxyzine and asenapine both have QT-prolonging potential, so combined use may increase the likelihood of torsades de pointes. Additive sedation is also possible.
How serious is the interaction between Asenapine transdermal and Hydroxyzine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer an alternative to hydroxyzine when asenapine is used. If both are required, check a baseline ECG and electrolytes and monitor the QTc after starting.
What other medicines interact with Hydroxyzine?
MediHelp also lists interactions of Hydroxyzine with, for example, Droperidol, Pimozide, Thioridazine. The full list is on the Hydroxyzine page.
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