Drug interactions
Hydroxyzine + OnabotulinumtoxinA
Severity: Moderate
Hydroxyzine and OnabotulinumtoxinA: 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
Drugs with anticholinergic activity may intensify the effects of botulinum toxin, with a theoretical risk of excess neuromuscular weakness or systemic anticholinergic effects. Clinical significance with hydroxyzine is probably low at usual doses.
What this interaction means in plain words
Hydroxyzine and OnabotulinumtoxinA 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.
Hydroxyzine belongs to Respiratory; OnabotulinumtoxinA belongs to Musculoskeletal.
Why it happens
Anticholinergic effects of hydroxyzine may add to the cholinergic transmission blockade at the neuromuscular junction from botulinum toxin.
What to do
Monitor for generalized weakness, swallowing or breathing difficulty after injection. Consider minimizing other anticholinergic agents around treatment.
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
Other interactions of OnabotulinumtoxinA
Frequently asked questions
Can I take Hydroxyzine with OnabotulinumtoxinA?
MediHelp rates the interaction as moderate. Hydroxyzine and OnabotulinumtoxinA 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. Drugs with anticholinergic activity may intensify the effects of botulinum toxin, with a theoretical risk of excess neuromuscular weakness or systemic anticholinergic effects. Clinical significance with hydroxyzine is probably low at usual doses.
How serious is the interaction between Hydroxyzine and OnabotulinumtoxinA?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for generalized weakness, swallowing or breathing difficulty after injection. Consider minimizing other anticholinergic agents around treatment.
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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