Overview: Hydroxyzine is an antihistamine that is used for certain types of anxiety, itching due to allergic conditions, to help you relax before and after general anesthesia, or for nausea and vomiting. Common side effects may include drowsiness and a dry mouth. Do not drive or do other activities that require alertness or coordination until you know how hydroxyzine affects you. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.
Uses
What is hydroxyzine used for?
Hydroxyzine is commonly used for the following conditions.
- Certain types of anxiety
- Itching due to certain allergic conditions
- Sedation (to help you relax) before and after receiving general anesthesia
- Nausea and vomiting
These uses may vary, depending on the specific hydroxyzine product prescribed. Hydroxyzine may also be used for other conditions as determined by your health care provider.
How does hydroxyzine work (mechanism of action)?
Hydroxyzine is an antihistamine. It works by blocking the effect of a substance in your body called histamine. It also works in parts of the brain to create a calming effect.
How is hydroxyzine supplied (dosage forms)?
Brands and other names
- Atarax
- Orgatrax
- Vistaril
Dosage forms and strengths
- 25 mg, 50 mg, 100 mg oral capsules
- 10 mg/5mL oral solution
- 10 mg, 25 mg, 50 mg oral tablets
Hydroxyzine is also available in injectable forms.
How should I store hydroxyzine?
Oral Products. Hydroxyzine products taken by mouth should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). They can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when you’re transporting them. Store them in a cool, dry place.
Injection Liquid. Hydroxyzine injection is usually given by a health care provider in a hospital or clinic. You will not store it at home.
Side Effects
What are the most common side effects of hydroxyzine?
The most common side effects of hydroxyzine are listed below. Tell your health care provider if you have any of these side effects that bother you.
- Drowsiness
- Dry mouth
There may be other side effects of hydroxyzine that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of hydroxyzine?
While less common, the most serious side effects of hydroxyzine are described below, along with what to do if they happen.
Severe Allergic Reactions. Hydroxyzine may cause allergic reactions, which can be serious. Stop using hydroxyzine and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Heart Rhythm Changes. Hydroxyzine may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take medicines that can prolong the QT interval. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.
Severe Skin Reactions. Hydroxyzine can cause a severe skin reaction called acute generalized exanthematous pustulosis (AGEP). Stop using hydroxyzine and call your health care provider right away if you get a rash, have a fever and small, pus-filled bumps on red and swollen skin, or if your skin condition is getting worse and not better.
Seizures. Some people who have used hydroxyzine have reported having convulsions, also known as seizures. There are many types of seizures, and some of them are not easy to recognize. Stop using hydroxyzine and call your health care provider if you have any of the following signs that a seizure is happening or could happen.
- Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
- Stiffening of your arms and legs
- Feeling anxious, nervous, confused, or a sense of dread
- Feeling dizzy or lightheaded
- Falling or losing consciousness
Severe Tissue Injury. Hydroxyzine injection can cause severe irritation and damage to tissues where it is injected. In some cases, this could lead to gangrene, tissue death, and other problems. Tell your health care provider right away if you have pain or burning near where the medicine is injected.
Warnings & Precautions
Who should not use hydroxyzine?
Allergies to Ingredients. People who are allergic to any of the following should not use hydroxyzine.
- Atarax
- Cetirizine
- Hydroxyzine
- Levocetirizine
- Orgatrax
- Vistaril
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific hydroxyzine products they stock.
Pregnancy. Do not use hydroxyzine early in pregnancy. If you become pregnant, contact your health care provider right away. See the Pregnancy subsection for more details.
Heart Rhythm Problems. Hydroxyzine should not be used if you have a certain type of electrocardiogram (EKG) problem, such as QT prolongation. Hydroxyzine can make this condition worse.
What should I know about hydroxyzine before using it?
Do not use hydroxyzine unless it has been prescribed to you by a health care provider. Use it as prescribed.
Do not share hydroxyzine with other people, even if they have the same condition as you. It may harm them.
Keep hydroxyzine out of the reach of children.
If you are taking hydroxyzine liquid, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist what measuring device to use.
Hydroxyzine can make you sleepy or affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how hydroxyzine affects you.
People who are 65 years and older can be at greater risk of some side effects from hydroxyzine. Talk to your health care provider about your risks if you are in this age group.
What should I tell my health care provider before using hydroxyzine?
Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if hydroxyzine is right for you.
In particular, make sure that you discuss any of the following.
Heart Problems. Tell your health care provider if you have any heart problems, including heart disease, a prior heart attack, heart failure, or heart rhythm problems. Also tell your health care provider if you have a family history of heart rhythm problems.
Other Medicines and Supplements. Hydroxyzine may interact with other medicines and supplements. Before using hydroxyzine, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. Do not use hydroxyzine early in pregnancy. Hydroxyzine may harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant. If you become pregnant, contact your health care provider right away. Your health care provider will let you know if you should use hydroxyzine later in pregnancy.
Breastfeeding. It is not known if hydroxyzine passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should stop breastfeeding or stop hydroxyzine.
Interactions
Does hydroxyzine interact with foods or drinks?
There are no known interactions between hydroxyzine and foods or drinks.
The risk of drowsiness may be increased if you drink alcohol while using hydroxyzine.
Does hydroxyzine interact with other medicines (drug interactions)?
Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before using hydroxyzine.
- A medicine used to control your heart rate or rhythm (antiarrhythmic)
- An antipsychotic, which is a medicine for certain mental health conditions
- An antidepressant, which is a medicine used for depression or anxiety
- An antibiotic, which is a medicine used for bacterial infections
- Methadone, which is an opioid medicine used to treat pain or opioid use disorder
- Ondansetron, which is a medicine used for nausea and vomiting
- A barbiturate, such as butalbital, phenobarbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
- Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, medicines for anxiety, or allergy medicines
- Any medicine that can cause QT prolongation, which is a potentially dangerous heart rhythm problem
- Pentamidine, which is a medicine used to prevent or treat a serious lung infection in people with immune system problems
This may not be a complete list of medicines that can interact with hydroxyzine. Always check with your health care provider.
Overdose/Missed Dose
What should I do if I accidentally use too much hydroxyzine?
If you or someone else has used too much hydroxyzine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of hydroxyzine?
If you miss a dose of oral hydroxyzine, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
Hydroxyzine injection is usually given by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving hydroxyzine injection as scheduled.
Are you currently using Hydroxyzine (Atarax, Vistaril, and others)?
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