Drug interactions
Donepezil + Hydroxyzine
Severity: Major
Donepezil and Hydroxyzine: major interaction.
Last updated Sources: US FDA label
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
Both drugs can prolong the QT interval, so combined use raises the risk of torsades de pointes. Hydroxyzine is also anticholinergic, which opposes donepezil's therapeutic effect.
What this interaction means in plain words
Donepezil 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.
Donepezil belongs to Central Nervous System; Hydroxyzine belongs to Respiratory.
Why it happens
Additive QT prolongation plus pharmacodynamic antagonism from hydroxyzine's antimuscarinic activity.
What to do
Avoid the combination where possible and choose a non-anticholinergic, non-QT-prolonging alternative. If it is needed, check an ECG and electrolytes and keep the hydroxyzine dose low.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Donepezil and Hydroxyzine, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
References
Other interactions of Donepezil
- Donepezil + Dronedarone Contraindicated
- Donepezil + Pimozide Contraindicated
- Donepezil + Thioridazine Contraindicated
- Donepezil + Vandetanib Contraindicated
- Amiodarone + Donepezil Major
- Amisulpride + Donepezil Major
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 Donepezil with Hydroxyzine?
MediHelp rates the interaction as major. Donepezil 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. Both drugs can prolong the QT interval, so combined use raises the risk of torsades de pointes. Hydroxyzine is also anticholinergic, which opposes donepezil's therapeutic effect.
How serious is the interaction between Donepezil 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: Avoid the combination where possible and choose a non-anticholinergic, non-QT-prolonging alternative. If it is needed, check an ECG and electrolytes and keep the hydroxyzine dose low.
What other medicines interact with Donepezil?
MediHelp also lists interactions of Donepezil with, for example, Dronedarone, Pimozide, Thioridazine. The full list is on the Donepezil page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
