Drug interactions
Donepezil transdermal + Hydroxyzine
Severity: Moderate
Donepezil transdermal and Hydroxyzine: moderate interaction.
Last updated
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
Donepezil increases cholinergic activity while hydroxyzine has anticholinergic properties, so each may blunt the effect of the other. This may reduce cognitive benefit in dementia and the anticholinergic burden may worsen confusion.
What this interaction means in plain words
Donepezil transdermal and Hydroxyzine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Why it happens
Pharmacodynamic antagonism between acetylcholinesterase inhibition and antimuscarinic activity.
What to do
Avoid hydroxyzine in patients with dementia taking donepezil where possible and choose a non-anticholinergic alternative. If used, monitor cognition and function.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 transdermal with Hydroxyzine?
MediHelp rates the interaction as moderate. Donepezil transdermal and Hydroxyzine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Donepezil increases cholinergic activity while hydroxyzine has anticholinergic properties, so each may blunt the effect of the other. This may reduce cognitive benefit in dementia and the anticholinergic burden may worsen confusion.
How serious is the interaction between Donepezil transdermal and Hydroxyzine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid hydroxyzine in patients with dementia taking donepezil where possible and choose a non-anticholinergic alternative. If used, monitor cognition and function.
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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