If you have certain conditions or are going to have surgery with sedation (a state of sleepiness and relaxation), you may be interested in learning more about hydroxyzine. It’s a generic prescription drug used for the following purposes in adults and some children:

Hydroxyzine comes as a tablet and capsule that you swallow. The tablet form is called hydroxyzine hydrochloride. The capsule form is called hydroxyzine pamoate. Hydroxyzine also comes as a liquid solution you take by mouth and in certain injectable forms, but those are not covered in this article.

All the forms contain the same active ingredient* (hydroxyzine), so this article will refer to both the tablet and capsule form as “hydroxyzine.”

Hydroxyzine can be used short term or long term, depending on the condition it’s used to treat.

This article describes hydroxyzine’s side effects. For more information about hydroxyzine, including details about its uses, see this in-depth article.

*An active ingredient is what makes a drug work.

Some people may experience mild to serious side effects during their hydroxyzine treatment. Not everyone will experience side effects. Examples of hydroxyzine’s commonly reported side effects include:

* To learn more about this side effect, see the “Side effects explained” section below.

If you experience side effects when you take hydroxyzine, they’ll likely be mild. Examples of mild side effects that have been reported with hydroxyzine include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking hydroxyzine unless your doctor recommends it.

Hydroxyzine may cause mild side effects other than the ones listed above. For details, see the prescribing information for hydroxyzine tablets and hydroxyzine capsules.

In rare cases, people may have serious side effects from taking hydroxyzine. Serious side effects that have been reported with hydroxyzine include:

  • cardiac side effects*
  • skin reactions, such as acute generalized exanthematous pustulosis or a serious rash
  • tremors
  • convulsions
  • uncontrolled movements
  • severe allergic reaction*

If you develop serious side effects while taking hydroxyzine, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* To learn more about this side effect, see the “Side effects explained” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with hydroxyzine, visit MedWatch.

Get answers to some frequently asked questions about hydroxyzine’s side effects.

Does hydroxyzine cause sexual side effects in women* or men*?

No, hydroxyzine isn’t known to cause sexual side effects. This kind of side effect wasn’t reported in studies of the drug.

If you’re concerned about sexual side effects during your hydroxyzine treatment, talk with your doctor. They may be able to determine the cause of these side effects and how to manage them.

* In this article, we use the terms “men” and women” to refer to someone’s sex assigned at birth. For information about the difference between sex and gender, see this article.

Is weight gain a side effect of hydroxyzine?

No, hydroxyzine shouldn’t cause weight gain. This wasn’t a side effect reported in studies of the drug.

If you’re concerned about changes in your weight, talk with your doctor. They may have some recommendations to help manage your weight.

Can hydroxyzine’s side effects vary depending on whether it’s taken for inducing sedation (a state of sleepiness and relaxation) or treating anxiety?

Your risk of certain side effects from hydroxyzine may vary based on factors such as your treatment length or the condition you’re taking the drug to treat. For instance, you may experience different side effects if you are taking it once for sedation before surgery compared with taking it long term for anxiety or itchy skin.

On the other hand, the risk of certain common side effects, such as sleepiness, is the same regardless of treatment length or the condition the drug is used to treat.

Certain people also have a higher risk of side effects based on their health status. See the “Hydroxyzine warnings” section below to learn about conditions that might make you more likely to have side effects from this drug.

Is my risk of side effects lower if I take the 25-mg dose of hydroxyzine compared with the 50-mg dose?

It depends. Hydroxyzine is used in lower doses in certain groups, such as older adults (ages 65 years and older), young children, and people with kidney or liver problems. The lower dose helps reduce the risk of side effects.

Studies did not specifically report more side effects in these populations when they took higher doses of hydroxyzine that fall within the recommended dosage range. But some side effects, such as seizures or slowed breathing, can occur if you take very high doses of hydroxyzine.

Your risk of having side effects depends on several factors. If you think you’re more likely to experience a side effect because of a condition you already have, talk with your doctor. They may decide to start your treatment with a lower dose, or they may recommend a different medication for you.

Do older people have a higher risk of side effects from hydroxyzine compared with younger people?

It’s possible. Older adults are more likely to have problems with their kidney and liver function, which means that their bodies may take longer to break down the drug.

In some cases, adults ages 65 years and older may be prescribed a lower dose of hydroxyzine to reduce the risk of side effects. People in this age group are more likely to have certain side effects from hydroxyzine, including sleepiness, confusion, and slurred speech.

Your doctor will monitor your body’s response to the drug and determine whether your dosage should be adjusted to ease your side effects. If you experience bothersome side effects during your hydroxyzine treatment or you’re concerned about your risk of a certain side effect, talk with your doctor.

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


Some people who take hydroxyzine may experience a headache. This was a common side effect reported in studies. In most cases, headaches from hydroxyzine are mild and usually go away on their own.

What might help

If you get a headache from taking hydroxyzine, below are ideas to help manage it:

  • Drink plenty of water each day.
  • Apply a warm or cool compress to your forehead.
  • Take an over-the-counter (OTC) pain reliever such as acetaminophen or ibuprofen. (Talk with your doctor or pharmacist first to make sure it’s safe to take with hydroxyzine.)
  • Try a natural headache remedy after checking with your doctor that it’s safe.

If your headache is bothersome or doesn’t go away, talk with your doctor about other ideas to treat it.

Cardiac side effects

Hydroxyzine may cause a cardiac (heart-related) side effect called long QT syndrome. With this condition, your heart takes longer than usual to contract and relax. This increases your risk of developing a life threatening abnormal heart rhythm called Torsade de Pointes.

If you feel fluttering or palpitations* in your chest or faint without a known cause, these could be signs of an abnormal heart rhythm.

* The term “palpitations” refers to a feeling of skipped or extra heartbeats.

What might help

If you think you may be experiencing a heart-related side effect during your hydroxyzine treatment, talk with your doctor or get medical care right away.

If you have a condition that causes abnormal heart rhythm or you take a medication that raises your risk of this side effect, your doctor may not prescribe hydroxyzine for you.

If you experience heart-related side effects during your treatment, your doctor may have you stop taking hydroxyzine and switch to a different medication.

Dry mouth

Some people may have dry mouth while taking hydroxyzine. In studies of the drug, dry mouth was a common side effect.

What might help

If you have dry mouth during your hydroxyzine treatment, you may be able to manage this side effect without medication. Some ideas to try include:

  • sipping water during the day
  • chewing sugar-free gum
  • using a humidifier in your home
  • avoiding caffeine

You can also talk with your doctor about whether an OTC saliva substitute in the form of a spray or lozenge might help.

Allergic reaction

Like most drugs, hydroxyzine can cause an allergic reaction in some people. This was a side effect in studies of the drug.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • a steroid you take by mouth
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to hydroxyzine, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to hydroxyzine, they may have you switch to a different treatment.

Keeping track of side effects

During your hydroxyzine treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how hydroxyzine affects you. They can then use this information to adjust your treatment plan if needed.

Hydroxyzine may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether hydroxyzine is a good treatment option for you.

Talk with your doctor about your health history before starting hydroxyzine. Factors to consider include those described below.

Age. Young children and older adults (ages 65 years and older) may have a higher risk of side effects from hydroxyzine. In both of these groups, doctors will likely prescribe a lower dose at the start of treatment.

Heart rhythm problems. Taking hydroxyzine can affect your heart rhythm. Some rare but serious problems with heart rhythm that can occur with hydroxyzine include long QT syndrome and Torsade de Pointe. If you already have an abnormal heart rhythm, your doctor may not prescribe hydroxyzine for you due to the risk of harm. They can suggest other treatments that are safer options for you.

Liver or kidney problems. If you have kidney or liver problems, your body might not break down hydroxyzine quickly enough. This could raise your risk of side effects from the drug. If you have liver or kidney problems, your doctor may start your treatment by prescribing a lower dose of the drug. Or they may recommend a different medication for you.

Drugs that interact with hydroxyzine. Hydroxyzine interacts with some other medications. Talk with your doctor about all the medications you take before you start hydroxyzine. Examples of drugs that interact with hydroxyzine include:

  • drugs that prolong a part of the heart rhythm called the QT interval, including quinidine, amiodarone (Pacerone), haloperidol (Haldol Decanoate), citalopram (Celexa), levofloxacin (Levaquin), and methadone (Methadose)
  • drugs that are central nervous system depressants, such as phenobarbital, oxycodone (Oxycontin), and alprazolam (Xanax)
  • monoamine oxidase inhibitors (MAOIs)
  • drugs that change the way certain liver enzymes that break down hydroxyzine work, such as phenytoin and ritonavir
  • anticholinergic drugs, including ipratropium (Atrovent HFA) and oxybutynin (Ditropan XL)

Conditions that affect breathing, urination, vision, muscle movements, and digestion. If you have one of these conditions, taking hydroxyzine can worsen it. Because of this, your doctor may prescribe a treatment other than hydroxyzine for your condition.

Before taking hydroxyzine, tell your doctor if you have:

Allergic reaction. If you’ve had an allergic reaction to hydroxyzine or any of its ingredients, your doctor will likely not prescribe hydroxyzine. Ask them what other medications are better options for you.

Also, let your doctor know if you’ve had an allergic reaction to Zyrtec (cetirizine) or Xyzal (levocetirizine), which are similar to hydroxyzine. Your doctor will likely not prescribe hydroxyzine due to the risk of harm.

Alcohol and hydroxyzine

You should not drink alcohol during your hydroxyzine treatment. Both alcohol and hydroxyzine can cause drowsiness, confusion, dizziness, lack of coordination, and memory problems. So combining alcohol with hydroxyzine can raise your risk of these side effects, or it could make the side effects worse if you experience them.

If you’re concerned about avoiding alcohol during your hydroxyzine treatment, talk with your doctor.

Pregnancy and breastfeeding while taking hydroxyzine

You should not take hydroxyzine during pregnancy or while breastfeeding. In fact, hydroxyzine is contraindicated in pregnancy and breastfeeding. (That means doctors will not prescribe this drug to people who are pregnant or breastfeeding due to the risk of harm.)

Hydroxyzine has been reported to cause harm to newborns who were exposed to the drug during pregnancy.

Possible symptoms that could occur in newborns who were exposed to hydroxyzine include:

In addition, hydroxyzine can pass into breast milk and cause side effects in a child who is breastfed.

If you’re pregnant or breastfeeding, or planning to become pregnant or to breastfeed, talk with your doctor about your treatment options.

If you have any questions about side effects that hydroxyzine can cause, talk with your doctor. You can also ask them about Vistaril, which is a brand-name version of the hydroxyzine capsule.

A generic drug and its brand-name version are expected to have the same side effects because they contain the same active ingredient. (An active ingredient is what makes a drug work.)

You can ask your doctor any questions you have about treatment with hydroxyzine. Here are a few possible questions:

  • Does hydroxyzine cause constipation or diarrhea?
  • Am I more likely to have drowsiness as a side effect when I first start hydroxyzine?
  • Can hydroxyzine cause hair loss?
  • Can hydroxyzine cause long-term side effects?
  • How do the side effects of hydroxyzine compare with other drugs used to treat anxiety?

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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.