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Hydroxyzine Hcl – Uses, Side Effects, and More

Below are recommended dosages for hydroxyzine oral tablet’s approved uses. Your doctor will prescribe the dosage that’s best for you.

All About Hydroxyzine Oral Tablet

If you have anxiety, allergies, or a planned surgery, your doctor may prescribe hydroxyzine oral tablet for you.

It’s a prescription drug that’s used in adults and some children to:

treat anxiety
treat itching related to dermatitis or other allergic conditions
help induce sedation (a state of sleepiness and relaxation) before or after you receive anesthesia for surgery

To learn more about these conditions and how hydroxyzine is used for them, see the “What is hydroxyzine used for?” section below.

Hydroxyzine oral tablet basics

Hydroxyzine is classified as an antihistamine.

You’ll take hydroxyzine oral tablets by mouth.

Americans see their primary care doctors less often than they did a decade ago. Adults under 65 made nearly 25% fewer visits to primary care providers in 2016 than they did in 2018, according to National Public Radio. In the same time period, the number of adults who went at least a year without visiting a primary care provider increased from 38% to 46%.

Note: Hydroxyzine also comes as capsules, syrup, and a solution that’s given by injection. Hydroxyzine hydrochloride is found in oral tablets. Other types of hydroxyzine are found in other forms of the drug. Only the oral tablet form is described in this article. If you’d like to learn about hydroxyzine’s other forms, talk with your doctor or pharmacist.

Hydroxyzine oral tablet brand-name versions

Hydroxyzine oral tablet isn’t available in a brand-name version.

Note: Hydroxyzine capsules are available as a brand-name drug. To learn about this version of hydroxyzine, talk with your doctor or pharmacist.

Hydroxyzine oral tablet is a generic drug, which means it’s an exact copy of the active drug in a brand-name medication. The brand-name medication that hydroxyzine oral tablet is based on was called Atarax. But brand-name Atarax is no longer available.

Generic drugs are thought to be as safe and effective as the brand-name drug they’re based on. In general, generics usually cost less than brand-name drugs.

Read this Healthline article to learn more about the differences between generic and brand-name drugs.

Like most drugs, hydroxyzine oral tablets may cause mild or serious side effects. The lists below describe some of the more common side effects that hydroxyzine oral tablets may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

your prescribed dosage
your age
other health conditions you have
other medications you may be taking

Your doctor or pharmacist can tell you more about the potential side effects of hydroxyzine oral tablets. They can also suggest ways to help reduce side effects. You can also check out this detailed article about hydroxyzine’s side effects.

Mild side effects

Here’s a short list of some of the mild side effects that hydroxyzine oral tablets can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read hydroxyzine oral tablet’s prescribing information.

Mild side effects of hydroxyzine oral tablet that have been reported include:

constipation
confusion
dry mouth
fatigue (lack of energy)
headache
insomnia (trouble falling asleep or staying asleep)
nausea
trouble concentrating
weakness
sleepiness*
low blood pressure*

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* For more information on this side effect, see the “Side effect focus” section below.

Serious side effects

Serious side effects from hydroxyzine oral tablets can occur, but they are not common. If you have serious side effects from hydroxyzine oral tablets, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of hydroxyzine oral tablets that have been reported include:

abnormal heart rhythm, such as long QT syndrome and torsades de pointes
skin reactions*
allergic reaction*

* For more information on this side effect, see the “Side effect focus” section below.

Side effect focus

Learn more about some of the side effects hydroxyzine oral tablet may cause.

Sleepiness

You may have sleepiness while you’re taking hydroxyzine oral tablets. This was a very common side effect reported in studies of the drug.

What might help

Because of your risk for sleepiness, you should avoid driving until you know how hydroxyzine oral tablets affect you.

Sleepiness from hydroxyzine oral tablets usually goes away after you’ve taken them for a few days. But if you have extreme sleepiness or sleepiness that doesn’t go away, tell your doctor. They may prescribe a lower dosage of the drug for you.

Low blood pressure

You may have low blood pressure while you’re taking hydroxyzine oral tablets.

This wasn’t a side effect reported in studies of the drug. Instead, low blood pressure from hydroxyzine was reported after the drug’s initial studies. Keep in mind, though, that low blood pressure is also a possible side effect with overdose of hydroxyzine oral tablets.

Skin reactions

You may have serious skin reactions while you’re taking hydroxyzine oral tablets. Skin reactions weren’t reported in studies of the drug. But these side effects have been reported since the drug’s initial studies.

Skin reactions that hydroxyzine may cause include:

acute generalized exanthematous pustulosis (AGEP), which is a rare condition that causes skin problems and high white blood cell levels
angioedema
erythema multiforme
excessive sweating
pemphigoid
Stevens-Johnson syndrome
toxic epidermal necrolysis

Some possible symptoms of the skin reactions listed above include:

blisters
fever
hives
itching
pustules (fluid-filled bumps on the skin)
rapid swelling underneath the skin
rash
raw, painful areas of skin
red, purple, or darkened skin color
skin irritation

What might help

Tell your doctor right away if you have symptoms of skin reactions from hydroxyzine oral tablets.

In some cases, skin reactions from hydroxyzine oral tablet can be life threatening. Call 911 or your local emergency number if you have fever, blisters, skin swelling, or painful areas of skin. These can be signs of a medical emergency that needs to be treated right away.

skin rash
itchiness
flushing (temporary warmth, redness, or deepening of skin color)

If you have anxiety, allergies, or a planned surgery, your doctor may prescribe hydroxyzine for you.

It’s a prescription drug that’s used to:

Treat anxiety. Anxiety is an unpleasant feeling of intense fear or worry about everyday situations. For this use, the drug is given for the short-term relief of anxiety symptoms.
Treat itching.Itching may be caused by allergies or other skin conditions such as hives, eczema, and dermatitis.
Help induce sedation. Sedation is a state of sleepiness and relaxation. For this use, the drug is given before or after you receive anesthesia for surgery.

For these purposes, hydroxyzine oral tablets are used in adults and children ages 1 year and older.

Hydroxyzine belongs to a group of drugs called antihistamines. It works by attaching to histamine receptors (binding sites) in your body. This produces a calming effect that helps relieve anxiety and itching.

Find answers to some commonly asked questions about hydroxyzine oral tablet.

Is hydroxyzine used to help with sleep? If it is, what’s the dosage?

Hydroxyzine is not approved to help with sleep. But it may be used off-label for this purpose. (Off-label use means a drug is given for a condition it hasn’t been approved to treat.)

Hydroxyzine can affect everyone differently. Both sleepiness and insomnia are possible side effects of the drug. (With insomnia, you have trouble falling asleep or staying asleep.)

So it’s possible that hydroxyzine may help you sleep. But the drug may also keep you awake.

You’ll know more about how hydroxyzine affects you after you’ve taken the drug for several days.

To learn more about using hydroxyzine to help with sleep, talk with your doctor.

How long do hydroxyzine’s effects last? And how long does it stay in your system?

Hydroxyzine is a type of drug called an antihistamine.

It works by attaching to histamine receptors (binding sites) in your body. This produces a calming effect that helps relieve anxiety and itching.

You may continue to have these effects from hydroxyzine for several hours after you take the drug.

Hydroxyzine’s half-life can be used to figure out how long the drug stays in your system. The half-life of a drug is the time it takes for half of a drug’s dose to leave your body. Hydroxyzine’s half-life is about 14 hours. So it takes about 14 hours for your body to get rid of half of a dose of hydroxyzine.

Typically, it takes about five half-lives for a drug to completely leave your system. For hydroxyzine, this means the drug will stay in your system for about 70 hours after your last dose.

To learn more about how hydroxyzine works and how long its effects last, talk with your doctor or pharmacist.

What should I know about hydroxyzine compared with Benadryl, Xanax, Lexapro, or Zoloft?

Hydroxyzine belongs to a group of drugs called antihistamines. It’s prescribed to:

treat anxiety
treat itching
help induce sedation (a state of sleepiness and relaxation) before or after you receive anesthesia for surgery

Diphenhydramine (Benadryl) is also an antihistamine. It’s available over the counter, so you don’t need a prescription for it. Benadryl is also used to treat itching and other allergy symptoms.

Is hydroxyzine a benzodiazepine or other type of controlled substance? Will it make me feel ‘high’?

Hydroxyzine isn’t a benzodiazepine or a controlled substance. (Controlled substances have a higher risk of being misused compared with other drugs.)

Instead, hydroxyzine belongs to a group of drugs called antihistamines.

You may feel calm and relaxed after taking hydroxyzine. But euphoria (feeling “high” or full of energy) wasn’t a side effect reported in studies of the drug. Additionally, hydroxyzine isn’t known to be addictive. (With addiction, a drug is taken even if it’s causing harmful outcomes.)

If you’re concerned about how hydroxyzine may affect you, talk with your doctor.

Does hydroxyzine cause weight gain?

Hydroxyzine probably doesn’t cause weight gain. This side effect wasn’t reported in studies of the drug.

If you’re concerned about weight gain while taking hydroxyzine, talk with your doctor. They can suggest healthy ways to manage your body weight.

Do certain side effects of hydroxyzine affect older people more than younger people?

Yes, hydroxyzine’s side effects may affect older people more than younger people.

Older people may have certain health conditions that affect how their bodies respond to hydroxyzine. These conditions include kidney and liver problems. And the conditions could increase the risk of side effects from hydroxyzine, such as sleepiness and confusion.

Because of this, hydroxyzine is not recommended for older people. If older people are prescribed the drug, it’s recommended that they start with a low dosage.

If you’re older in age, talk with your doctor about the risks and benefits of using hydroxyzine.

Does hydroxyzine have a certain dosage for panic attacks?

Hydroxyzine isn’t currently approved to treat panic attacks. But hydroxyzine may be used off-label for this purpose. (Off-label use means a drug is given for a condition it hasn’t been approved to treat.)

Panic attacks are sudden episodes of fear that happen without an apparent reason. They can cause symptoms such as:

chest pain
increased heart rate
shaking
shortness of breath
trouble breathing

To learn more about using hydroxyzine to treat panic attacks and a recommended dosage for this use, talk with your doctor.

Your doctor will recommend the dosage of hydroxyzine oral tablets that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Form and strengths

You’ll take hydroxyzine oral tablets by swallowing them. They come in these strengths:

10 (milligrams) mg
25 mg
50 mg

Recommended dosages

Below are recommended dosages for hydroxyzine oral tablet’s approved uses. Your doctor will prescribe the dosage that’s best for you.

Dosage to treat anxiety

To treat anxiety, your doctor will probably have you start by taking 50 mg to 100 mg of hydroxyzine, in divided doses. This means you’ll take 12.5-mg to 25-mg doses two to four times each day.

The maximum recommended dosage for anxiety in adults is 100 mg, taken up to four times each day.

Dosage to induce sedation

To induce sedation, the recommended dosage of hydroxyzine is 100 mg taken in divided doses. (Sedation is a state of sleepiness and relaxation before or after you receive anesthesia for surgery.)

Your doctor will provide detailed directions on how to take hydroxyzine for this purpose. Or they’ll administer your dose at a healthcare facility.

Dosage to treat itching

To treat itching, the recommend starting dosage of hydroxyzine is 25 mg. You’ll take this dose once each night.

Your doctor may increase your dosage to 25 mg three or four times per day. They’ll recommend this depending on how hydroxyzine works for your condition.

Questions about hydroxyzine oral tablet’s dosage

Below are some common questions about hydroxyzine oral tablet’s dosage.

What if I miss a dose of hydroxyzine oral tablets? Take your missed dose as soon as you remember. But if it’s almost time for your next dose, skip the missed dose. Then take your next dose at the regular time. If you are not sure whether to skip a dose or take it, talk with your doctor or pharmacist.
Will I need to use hydroxyzine oral tablets long term? No, you likely won’t use hydroxyzine oral tablets long term. This medication should only be taken as long as it’s needed to treat your condition. This drug has not been studied for more than 4 months of use for treating anxiety. Your doctor will tell you how long you should take hydroxyzine oral tablets.
How long do hydroxyzine oral tablets take to work? You should notice hydroxyzine working to relieve your symptoms within 1 hour of taking the tablets. Some people may feel effects as soon as 15 to 30 minutes after a dose.

Hydroxyzine Hcl – Uses, Side Effects, and More

Hydroxyzine is used to treat itching caused by allergies. It is an antihistamine and works by blocking a certain natural substance (histamine) that your body makes during an allergic reaction. Hydroxyzine may also be used short-term to treat anxiety or to help you feel sleepy/relaxed before and after surgery.

How to use Hydroxyzine Hcl

Take this medication by mouth with or without food as directed by your doctor, usually three or four times daily. If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.

The dosage is based on your age, medical condition, and response to treatment. In children, the dosage may also be based on weight. Do not increase your dose or take this medication more often than directed.

Tell your doctor if your condition does not improve or if it worsens.

Side Effects

Drowsiness, dizziness, blurred vision, constipation, or dry mouth may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

To relieve dry mouth, suck (sugarless) hard candy or ice chips, chew (sugarless) gum, drink water, or use a saliva substitute.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including: mental/mood changes (such as restlessness, confusion, hallucinations), shaking (tremor), difficulty urinating.

Get medical help right away if you have any very serious side effects, including: seizures, fast/irregular heartbeat, severe dizziness, fainting.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US – Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada – Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Precautions

Before taking hydroxyzine, tell your doctor or pharmacist if you are allergic to it; or to cetirizine; or to levocetirizine; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of: breathing problems (such as emphysema, asthma), high pressure in the eye (glaucoma), high blood pressure, kidney problems, liver problems, seizures, stomach/intestine problems (such as ulcer, blockage), overactive thyroid (hyperthyroidism), difficulty urinating (for example, due to enlarged prostate).

Hydroxyzine may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.

The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before taking hydroxyzine, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).

Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/”water pills”) or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about taking hydroxyzine safely.

This drug may make you dizzy or drowsy or blur your vision. Alcohol or marijuana (cannabis) can make you more dizzy or drowsy. Do not drive, use machinery, or do anything that needs alertness or clear vision until you can do it safely. Avoid alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

Liquid products may contain sugar and/or alcohol. Caution is advised if you have diabetes, liver disease, or any other condition that requires you to limit/avoid these substances in your diet. Ask your doctor or pharmacist about using this product safely.

Children may be more sensitive to the side effects of this drug. This drug can often cause excitement in young children instead of drowsiness.

Older adults may be more sensitive to the side effects of this drug, especially drowsiness, confusion, constipation, trouble urinating or QT prolongation (see above). Drowsiness and confusion can increase the risk of falling.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breast-feeding.

Hydroxyzine Hcl – Uses, Side Effects, and More