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Generic name: hydroxyzine (hye DROKS i zeen)
Brand name: Vistaril®
Hydroxyzine is an antihistamine. It is approved for the treatment of anxiety. However, hydroxyzine is also used to treat difficulty sleeping, nausea, vomiting, itching, skin rash, and allergies.
Symptoms of anxiety include:
Do not drive a car or operate machinery until you know how this medication affects you because you may notice that you feel tired or dizzy.
Hydroxyzine is not a controlled substance. It does not have the risk of addiction like some other medications used to treat anxiety e.g., lorazepam (Ativan®), alprazolam (Xanax®), clonazepam (Klonopin®), and other benzodiazepines.
If you are pregnant or planning to become pregnant, notify your health care provider to best manage your medications. People living with anxiety disorders who wish to become pregnant face important decisions. It is important to discuss this with your doctor and caregivers.
Hydroxyzine should not be used in the first trimester of pregnancy. Studies that were done with mice, rabbits, and rats found an increased risk of birth defects. The risk to humans in the first trimester is unclear due to lack of well-controlled studies in humans. Hydroxyzine may be used in the second and third trimesters of pregnancy, but it should not be used during or just prior to labor. Use of hydroxyzine during labor may increase seizure risk in infants, decrease fetal heart rate, and increase side effects when combined with narcotics.
Regarding breastfeeding, use is not recommended since hydroxyzine does pass into breast milk. Infants who have received other antihistamines have experienced drowsiness, irritability, or unusual excitement. In addition, it may lower milk production in the mother.
Hydroxyzine may be taken with or without food. Take with food if you experience an upset stomach.
Hydroxyzine may be taken every day at regular times or on an as needed (“PRN”) basis. Typically, your health care provider will limit the number of doses you should take in one day.
Your health care provider will determine the dose and method of taking the medication that is right for you based upon your response.
If you take the medication every day (instead of ‘as needed’), use a calendar, pillbox, alarm clock, or cell phone alert to help you remember to take it. You may also ask a family member or friend to remind you or check in with you to be sure you are taking your medication.
If you miss a dose of hydroxyzine, take it as soon as you remember, unless it is closer to the time of your next dose. Discuss this with your health care provider. Do not double your next dose or take more than what is prescribed.
Avoid drinking alcohol and using illegal drugs while you are taking hydroxyzine. They may decrease the benefits (e.g., worsen your condition) and increase the adverse effects (e.g., sedation) of the medication.
If an overdose occurs call your doctor or 911. You may need urgent medical care. You may also contact the poison control center at 1-800-222-1222.
Symptoms of overdose include severe drowsiness, dry mouth, difficulty urinating, headache, rapid heartbeat, confusion, impaired coordination, slow reflexes, seizures, or coma.
A specific treatment to reverse the effects of hydroxyzine does not exist.
Common side effects
Rare/serious side effects
To date, there are no known problems associated with the long-term use of hydroxyzine. It is a safe and effective medication when used as directed.
A physician should reassess periodically the usefulness of the drug for the individual patient.
The following medications may increase the levels and effects of hydroxyzine:
Symptoms of anxiety or insomnia may improve within hours of the first dose of medication.
Hydroxizine does not have any black box warnings.
©2022 The American Association of Psychiatric Pharmacists (AAPP) and the National Alliance on Mental Illness (NAMI). AAPP and NAMI make this document available under the Creative Commons Attribution-No Derivatives 4.0 International License. Last Updated: January 2016.
This information is being provided as a community outreach effort of the American Association of Psychiatric Pharmacists. This information is for educational and informational purposes only and is not medical advice. This information contains a summary of important points and is not an exhaustive review of information about the medication. Always seek the advice of a physician or other qualified medical professional with any questions you may have regarding medications or medical conditions. Never delay seeking professional medical advice or disregard medical professional advice as a result of any information provided herein. The American Association of Psychiatric Pharmacists disclaims any and all liability alleged as a result of the information provided herein.