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

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

  • treat anxiety
  • treat itching
  • 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 oral tablet used for?” section below.

Hydroxyzine oral tablet basics

Hydroxyzine is classified as an antihistamine.

You’ll take hydroxyzine oral tablets by mouth.

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.

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:

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:

* 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.

Your risk for low blood pressure from hydroxyzine is higher if you have heart problems. It’s also higher if you take antidepressant drugs called monoamine oxidase inhibitors (MAOIs).

You may not have symptoms of low blood pressure unless your blood pressure is extremely low. Symptoms of extremely low blood pressure can include:

What might help

Before starting hydroxyzine oral tablets, tell your doctor about all of your health conditions and the medications you take.

Call your doctor right away if you have symptoms of extremely low blood pressure while you’re taking 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:

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.

Allergic reaction

Some people may have an allergic reaction to hydroxyzine oral tablets. Allergic reactions to hydroxyzine were reported after the drug’s initial studies were done.

Symptoms of a mild allergic reaction can include:

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

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to hydroxyzine oral tablets. But if you think you’re having a medical emergency, call 911 or your local emergency number.

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.

Alprazolam (Xanax), escitalopram (Lexapro), and sertraline (Zoloft) are prescription drugs that can be used for anxiety. Xanax is a benzodiazepine, while Lexapro and Zoloft are antidepressants.

To learn more about how hydroxyzine compares with these medications, talk with your doctor or pharmacist.

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:

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

Your doctor will explain how you should take hydroxyzine oral tablets. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions. Below are commonly used dosages, but always take the dosage your doctor prescribes.

Taking hydroxyzine oral tablet

You’ll take hydroxyzine oral tablets by mouth.

They’re available in the following strengths:

  • 10 milligrams (mg)
  • 25 mg
  • 50 mg

Dosage

How often you’ll take hydroxyzine oral tablets varies depending on the reason you’re taking them. For instance:

  • For anxiety, you’ll take hydroxyzine oral tablets up to four times per day.
  • For itching, you’ll take hydroxyzine oral tablets three or four times per day.
  • For sedation (a state of sleepiness and relaxation), your doctor will tell you how often you’ll need to take hydroxyzine oral tablets.

Your doctor may prescribe a lower dosage than usual if you’re older in age or have kidney or liver problems.

The maximum dose of hydroxyzine oral tablets is 100 mg per day.

Questions about taking hydroxyzine oral tablet

Here are answers to some common questions about taking hydroxyzine oral tablets.

  • 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 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 for.
  • Can hydroxyzine oral tablets be chewed, crushed, or split? The manufacturer of hydroxyzine hasn’t specified if these tablets can be chewed, crushed, or split. If you have trouble swallowing hydroxyzine tablets whole, talk with your doctor or pharmacist.
  • Should I take hydroxyzine oral tablets with food? You can take hydroxyzine oral tablets with food or without it.
  • 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.
Questions for your doctor

You may have questions about hydroxyzine oral tablets and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions like:
    • How will hydroxyzine oral tablets affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare professionals are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

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.

When considering treatment with hydroxyzine oral tablets, it’s important to talk with your doctor. Some important topics to discuss with them include:

  • all medical conditions you have
  • your overall health

These considerations and others are described in more detail below.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking hydroxyzine oral tablet, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with hydroxyzine oral tablets.

Interactions with drugs or supplements

Hydroxyzine oral tablets can interact with several types of drugs. These include:

This list does not contain all types of drugs that may interact with hydroxyzine oral tablets. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of hydroxyzine oral tablet.

* Because of this interaction, you should not take hydroxyzine with this type of drug.

Warnings

Hydroxyzine oral tablets may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take hydroxyzine oral tablets. Factors to consider include those in the list below.

  • Heart problems. Before taking hydroxyzine oral tablets, tell your doctor about any heart problems you have. Hydroxyzine can cause abnormal heart rhythms and low blood pressure. Your risk for these side effects is higher if you already have heart problems before taking hydroxyzine.
  • Liver or kidney problems. If you have liver or kidney problems, tell your doctor before starting hydroxyzine oral tablets. Your doctor may need to adjust your dosage of the drug. They may also monitor you more closely for side effects from hydroxyzine.
  • Allergic reaction. If you’ve had an allergic reaction to hydroxyzine oral tablets or any of their ingredients, you should not take this drug. Also tell your doctor if you’ve had an allergic reaction to cetirizine (Zyrtec) and levocetirizine (Xyzal). These drugs are similar to hydroxyzine. Ask your doctor about other medications that might be better options for you.
  • Conditions that affect breathing, digestion, muscle movements, urination, and vision. Hydroxyzine can worsen these conditions. If you have one of these conditions, your doctor may recommend a treatment other than hydroxyzine. Before taking hydroxyzine oral tablets, tell your doctor if you have:
    • breathing problems, such as asthma
    • trouble urinating
  • Use of monoamine oxidase inhibitors (MAOIs). You should not take hydroxyzine oral tablets with MAOIs. MAOIs are a group of drugs used to treat depression. Taking hydroxyzine with MAOIs can raise your risk for certain side effects of hydroxyzine. These include low blood pressure, trouble breathing, and decreased activity of your central nervous system. Before starting hydroxyzine oral tablets, tell your doctor if you take MAOIs. They’ll likely prescribe a drug other than hydroxyzine for you.
  • Taking drugs that may cause abnormal heart rhythm. You should not take hydroxyzine oral tablets with certain drugs that can cause abnormal heart rhythm. Because hydroxyzine can also cause this side effect, taking the drugs together increases your risk for heart rhythm problems. Examples of these drugs include:

Use with alcohol

You should not drink alcohol while you’re taking hydroxyzine oral tablets.

Drinking alcohol while taking hydroxyzine can worsen certain side effects of the drug. These side effects include:

If you have questions about drinking alcohol while taking hydroxyzine oral tablets, talk with your doctor.

Pregnancy and breastfeeding

You should not take hydroxyzine oral tablets while you’re pregnant or breastfeeding.

Hydroxyzine’s side effects in people who used the drug during pregnancy haven’t been studied. But the drug is known to cause harm in newborns who were exposed to the drug during pregnancy.

Below are possible symptoms that may happen in newborns after birth:

Additionally, hydroxyzine can pass into breast milk. So side effects of hydroxyzine can affect a child who is breastfed by someone taking the drug. (To learn about possible side effects of hydroxyzine, see the “What are hydroxyzine oral tablet’s side effects?” section above.)

If you’re pregnant, breastfeeding, or planning to become pregnant or breastfeed, talk with your doctor. They’ll probably prescribe a drug other than hydroxyzine for you.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for hydroxyzine oral tablets in your area, visit GoodRx.com.

Financial assistance to help you pay for hydroxyzine oral tablet may be available. Medicine Assistance Tool and NeedyMeds are two websites that provide resources to help reduce the cost of hydroxyzine oral tablets.

These websites also offer tools to help you find low-cost healthcare and certain educational resources. To learn more, visit their websites.

Do not take more hydroxyzine oral tablets than your doctor prescribes. Using more than this can lead to serious side effects.

Symptoms of overdose

Symptoms caused by an overdose of hydroxyzine oral tablets can include:

What to do in case you take too much hydroxyzine oral tablet

Call your doctor if you think you’ve taken too much hydroxyzine oral tablet. You can also call 800-222-1222 to reach the American Association of Poison Control Centers, or use their online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

If you have questions about using hydroxyzine for anxiety, itching, or sedation, talk with your doctor. (Sedation is a state of sleepiness and relaxation.)

You may want to ask your doctor about other treatments for these conditions. Below are a few articles you may find helpful:

Also, here are a few questions you may want to ask your doctor about hydroxyzine oral tablets:

  • How long should I take hydroxyzine oral tablets?
  • Should I use other treatments for anxiety, itching, or sedation while I’m taking hydroxyzine?
  • Can I take hydroxyzine oral tablets with acetaminophen (Tylenol) or ibuprofen (Advil)?
  • Will I have withdrawal symptoms if I stop taking hydroxyzine oral tablets?

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.