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*Based on a review of more than 8,800 K Health users who completed 3 months of treatment for anxiety or depression


What is hydroxyzine?

Man holding up a bottle of medication and smiling

Hydroxyzine is an antihistamine medication approved by the FDA for patient use in adults and children for the treatment of allergic skin conditions, including hives and contact dermatitis. It can also be used alone or with other medications to relieve anxiety and tension as well as a sedative before and after general anesthesia for surgery. Other uses for hydroxyzine include treatment of insomnia, nausea, vomiting, and allergies.

Examples of other antihistamine medications include cetirizine (Zyrtec) and fexofenadine (Allegra). An examples of another sedative and hypnotic medication is zolpidem (Ambien).

Do you need a prescription for hydroxyzine?

Yes, hydroxyzine and its brand-name forms, including Vistaril and Atarax, are only available with a prescription.

Before starting hydroxyzine, it’s important to speak with your provider about your medical history, symptoms, and any other medications you’re currently taking. It’s also important to disclose whether you’re pregnant or breastfeeding before taking the medication. The safety of hydroxyzine has not been established in pregnancy.

If your provider prescribes hydroxyzine for your symptoms, it’s important to keep them in the loop if any serious side effects arise, such as tremors, confusion, seizures, or restless muscle movements.

How does hydroxyzine work?

Hydroxyzine works by reducing the effects of the chemical histamine. Histamine can cause reactions of the skin, including itching or hives. Hydroxyzine can work to treat these types of skin reactions.

However, hydroxyzine also limits activity in the central nervous system. This is why it can work as an effective sedative when treating anxiety and tension. When combined with other medications, it can also be given before and after general anesthesia.

How long does it take for hydroxyzine to work?

Hydroxyzine can start to improve symptoms of anxiety and insomnia within hours of taking the first dose of the medication.

If you’ve been prescribed hydroxyzine for the treatment of a skin reaction, you may start to feel relief of your symptoms even sooner.

Is there a generic for hydroxyzine?

Hydroxyzine is a generic prescription medication, but it is also available under several brand-name prescription medications.

Brand-name forms of the prescription medication include Vistaril, Orgatrax, Hypam, and Atarax.

It’s important to note that the primary difference between brand-name and generic medications is cost. Generic medications are often sold at lower prices than their brand-name versions.

There should not be a difference in the safety or efficacy of these medications. In fact, in order to meet FDA standards, the generic form of any medication must be “bioequivalent” to the brand-name version of the drug. This means that it must have the same active ingredients, be available at the exact dosage, and be equally effective at treating the medical condition or conditions for which it is intended.

Side effects

Hydroxyzine can cause side effects. Possible side effects of hydroxyzine use include:

  • Blurred vision
  • Constipation
  • Dizziness
  • Drowsiness
  • Dry mouth
  • Fatigue
  • Headache
  • Urinary retention

More severe side effects are also possible. Examples of serious side effects include:

  • Confusion
  • Difficulty breathing or swallowing
  • Fever
  • Hallucinations
  • Increased heart rate or unsafe heartbeat
  • Priapism (erection that doesn’t go away after 4 hours)
  • Pus-filled, blister-like sores
  • Rash, hives, and/or itching
  • Seizures
  • Swelling or redness of the skin
  • Swelling of the lips, tongue or face
  • Unintentional trembling or shaking movements

If you experience signs of any of these side effects, go to the emergency department immediately.


Before taking hydroxyzine, it’s important to talk to your provider about the recommended dose and method of taking the medication. It’s also important to keep your provided in the loop as to how you’re feeling when taking the medication.

Hydroxyzine is available in capsule, tablet, syrup, or suspension form. It can be taken multiple times a day every day or on an as needed basis. How often you should take the medication will depend on your symptoms, medical history, and provider’s recommendation.

Regardless of which form of hydroxyzine you take, the medication can be taken with or without food. If you take hydroxyzine in suspension form, be sure to shake the suspension well before each use.

When taking hydroxyzine or any medication, it’s important to follow the instructions on the label exactly as directly and to follow any instructions given by your pharmacist or provider. Never double up on doses if you forget to take a dose.

It’s also important not to take more or less of the medication than as prescribed by your doctor. If you’d like to change your dosage, speak with your medical provider first.


You should avoid drinking alcohol and using illegal drugs if you’re taking hydroxyzine, as these can decrease the benefits of the medication and increase possible side effects, including sedation.

There are several medications that can also interact poorly with hydroxyzine, including some sleeping pills, narcotic pain medicines, muscle relaxers, and other forms of anxiety, depression, and seizure medication.

Before taking hydroxyzine, it’s important to talk with your provider about any prescription drugs, vitamins, over-the-counter medicines, and/or supplements you’re currently taking to avoid possible drug interactions.

Examples of medications that can interact with hydroxyzine include:

  • Antibiotics (like azithromycin)
  • Antidepressants (like Celexa or Prozac)
  • Antihistamines (like Benadryl or Zyrtec)
  • Antipsychotics
  • Heart rhythm medicine (like Cordarone or Nexterone)
  • Medications to treat cancer
  • Medications to treat malaria
  • Medications to treat HIV/AIDS
  • Methadone


Generally, the cost of any medication will vary depending on several factors, including your recommended dosage, your insurance coverage, and the rates available at your local pharmacy.

If you’re interested in keeping the cost of your hydroxyzine prescription low, shopping online can help. It’s an easy and convenient way to get your prescription at the lowest price.

Is hydroxyzine right for you?

Hydroxyzine isn’t right for everyone, especially people who are pregnant, breastfeeding, or on certain medications. If you’re interested in learning more about whether or not hydroxyzine may be right for you, reach out to a licensed medical provider to discuss your options.

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