{"id":629512,"date":"2024-08-20T10:44:49","date_gmt":"2024-08-20T14:44:49","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=629512"},"modified":"2026-08-06T13:33:51","modified_gmt":"2026-08-06T17:33:51","slug":"hydroxyzine-pamoate-vs-hcl","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/hydroxyzine-pamoate-vs-hcl\/","title":{"rendered":"Hydroxyzine pamoate vs. HCl: What\u2019s the difference?"},"content":{"rendered":"<p><a href=\"https:\/\/www.singlecare.com\/prescription\/hydroxyzine-hcl\/what-is\">Hydroxyzine<\/a>, a common anti-anxiety and antihistamine prescription medication, comes in two forms: hydrochloride (HCl) and pamoate. They both contain the same active drug, but they have different salt forms (pamoate vs. hydrochloride).\u00a0 There are virtually no other established differences between hydroxyzine pamoate versus. HCl, but recent studies suggest pamoate may provide an extra boost for treating <a href=\"https:\/\/www.singlecare.com\/conditions\/itchy-skin-causes\">itchy skin<\/a>.<\/p>\n<h2 id=\"key-differences\"><span style=\"font-weight: 500;\">Key differences\u00a0<\/span><\/h2>\n<p>Hydroxyzine HCl and hydroxyzine pamoate contain the same active ingredient and are used to treat the same conditions. The main difference is the salt form of the drug.<\/p>\n<p>Hydroxyzine is a chemical compound that contains carbon, hydrogen, chloride, nitrogen, and oxygen atoms.<\/p>\n<p>To make a drug, hydroxyzine is combined with other compounds to form a salt.<\/p>\n<ul>\n<li>When hydroxyzine bonds with hydrogen chloride (HCl), it\u2019s called hydroxyzine HCl. You may also see this referred to as <a href=\"https:\/\/books.google.com\/books?id=5GpcTQD_L2oC&amp;pg=PA532#v=onepage&amp;q&amp;f=false\">hydroxyzine dihydrochloride<\/a>.<\/li>\n<li>When hydroxyzine bonds with pamoic acid, it\u2019s called hydroxyzine pamoate. Some publications call it hydroxyzine embonate.<\/li>\n<\/ul>\n<p>So, hydroxyzine HCl and hydroxyzine pamoate have different salt forms, but they deliver the same active ingredient: hydroxyzine.<\/p>\n<h3 id=\"why-does-the-chemical-structure-matter\"><span style=\"font-weight: 500;\">Why does the chemical structure matter?<\/span><\/h3>\n<p>Because hydroxyzine HCl and hydroxyzine pamoate have different salt forms, there may be minor differences in how the medications are absorbed in the body. However, these differences are not considered clinically significant, and the two medications are equally effective.<\/p>\n<p>\u201cStudies indicate that the blood concentration of hydroxyzine HCl peaks much earlier, and the absorption curve of hydroxyzine pamoate is much slower and sustained,\u201d says <a href=\"https:\/\/raymonddouglasmd.com\/meet-dr-douglas\">Raymond Douglas<\/a>, MD, a California-based oculoplastic and reconstructive surgeon. \u201cI sometimes refer to HCl as a sprinter and pamoate as a marathon runner.\u201d<\/p>\n<p>That said, the prescribing labels for both types of hydroxyzine say they can start working in 15 to 30 minutes.<\/p>\n<p>\u201cSince the active drug is the same, both drugs will be equally effective when they enter your bloodstream,\u201d Dr. Douglas says.<\/p>\n<p><a href=\"https:\/\/www.epiphanywellnesscenters.org\/contributors\/jameslyons\">James Lyons<\/a>, MD, clinical adviser at Epiphany Wellness, says the different chemical structures also affect the way patients can take hydroxyzine. Because hydroxyzine HCl dissolves in water, it comes not only in an oral tablet, but also as an injection and oral liquid.<\/p>\n<p>\u201cHydroxyzine HCl comes in a variety of formulations and has a greater number of applications beyond oral administration, so it\u2019s used much more frequently,\u201d Dr. Lyons says. \u201cHowever, the salt designation (HCl vs. pamoate) is not nearly as important as the dosage level when thinking about the effectiveness of the drug.\u201d<\/p>\n<h3 id=\"is-hydroxyzine-salt\"><span style=\"font-weight: 500;\">Is hydroxyzine salt?<\/span><\/h3>\n<p>Both types of hydroxyzine are called \u201csalts,\u201d but this doesn\u2019t mean they\u2019re related to table salt.<\/p>\n<p>Hydroxyzine is a weak base. When it reacts with an acid (like hydrochloric acid or pamoic acid), chemists call the resulting product (hydroxyzine HCl or hydroxyzine pamoate) a salt.<\/p>\n<h3 id=\"do-hydroxyzine-salts-have-different-brand-names\"><span style=\"font-weight: 500;\">Do hydroxyzine salts have different brand names?\u00a0<\/span><\/h3>\n<p>In the U.S., all name-brand versions of hydroxyzine HCl have been discontinued due to the widespread availability of the more affordable generic. Hydroxyzine pamoate is still available under the brand name Vistaril.<\/p>\n<table class=\" singlecare-table\" role=\"table\">\n<thead>\n<tr>\n<th colspan=\"3\">\n<h3 id=\"compare-hydroxyzine-pamoate-vs-hydroxyzine-hcl-key-differences\"><span style=\"font-weight: 500;\">\u00a0 \u00a0 Compare hydroxyzine pamoate vs. hydroxyzine HCl key differences<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"header-row\">\n<td><b>Feature<\/b><\/td>\n<td><b>Hydroxyzine pamoate\u00a0<\/b><\/td>\n<td><b>Hydroxyzine HCl\u00a0<\/b><\/td>\n<\/tr>\n<tr>\n<td><b>Drug class<\/b><\/td>\n<td>Antihistamine \/ anxiolytic<\/td>\n<td>Antihistamine \/ anxiolytic<\/td>\n<\/tr>\n<tr>\n<td><b>Brand\/generic status<\/b><\/td>\n<td>Brand and generic<\/td>\n<td>Generic only<\/td>\n<\/tr>\n<tr>\n<td><b>Generic name<\/b><\/td>\n<td>Hydroxyzine pamoate<\/td>\n<td>Hydroxyzine HCl<\/td>\n<\/tr>\n<tr>\n<td><b>Dosage forms<\/b><\/td>\n<td>Capsule<\/td>\n<td>Tablet, solution, intramuscular injection<\/td>\n<\/tr>\n<tr>\n<td><b>Available strengths<\/b><\/td>\n<td>25 mg, 50 mg capsules<\/td>\n<td>10 mg, 25 mg, 50 mg tablets<\/td>\n<\/tr>\n<tr>\n<td><b>Typical treatment duration<\/b><\/td>\n<td>As needed<\/td>\n<td>As needed<\/td>\n<\/tr>\n<tr>\n<td><b>Who typically uses it<\/b><\/td>\n<td>Adults and children with anxiety or allergic itching<\/td>\n<td>Adults and children with anxiety or allergic itching<\/td>\n<\/tr>\n<tr>\n<td><b>Requires prescription?<\/b><\/td>\n<td>Yes<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td><b>Controlled substance?<\/b><\/td>\n<td>No<\/td>\n<td>No<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 id=\"conditions-treated\">Conditions treated<\/h2>\n<p><a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/lookup.cfm?setid=8e5fce17-936e-46ea-a969-518c952c2091\">Hydroxyzine HCl<\/a> and <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/lookup.cfm?setid=06068fff-2e79-4721-bcc7-b0938aa20e7a\">hydroxyzine pamoate<\/a> have been approved by the U.S. Food and Drug Administration (FDA) for the same indications:<\/p>\n<ul>\n<li>Relieving anxiety and tension<\/li>\n<li>Soothing itchy skin caused by allergic conditions like atopic dermatitis<\/li>\n<li>Causing sedation before or after general anesthesia<\/li>\n<\/ul>\n<p>Some healthcare professionals also prescribe hydroxyzine to improve sleep (an off-label use) or treat nausea and vomiting. Hydroxyzine\u2019s sedative effects may also enhance the pain-relieving effects of opioid medications, so healthcare providers sometimes prescribe hydroxyzine as an add-on treatment to opioids.<\/p>\n<p>Healthcare professionals may inject hydroxyzine HCl to offer quick <a href=\"https:\/\/www.singlecare.com\/conditions\/anxiety-treatment-and-medications\">anxiety relief<\/a> or sedation when oral medication isn\u2019t available. For example, it <a href=\"https:\/\/dailymed.nlm.nih.gov\/dailymed\/lookup.cfm?setid=7279ad5a-0a49-432d-8fa2-17e4c6ecbadc\">may be used<\/a> to calm someone who feels stressed about visiting the dentist.<\/p>\n<table class=\" singlecare-table\" role=\"table\">\n<thead>\n<tr>\n<th colspan=\"3\">\n<h3 id=\"compare-hydroxyzine-pamoate-vs-hydroxyzine-hcl-conditions-treated\"><span style=\"font-weight: 500;\">\u00a0 \u00a0Compare hydroxyzine pamoate vs. hydroxyzine HCl conditions treated<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"header-row\">\n<td><b>Condition\/use<\/b><\/td>\n<td><b>Hydroxyzine pamoate<\/b><\/td>\n<td><b>Hydroxyzine HCl<\/b><\/td>\n<\/tr>\n<tr>\n<td><b>Anxiety and tension<\/b><\/td>\n<td>Yes<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td><b>Pruritus (itching) from allergic conditions<\/b><\/td>\n<td>Yes<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td><b>Pre- and post-operative sedation<\/b><\/td>\n<td>Yes<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td><b>Acute anxiety\/nausea (injection)<\/b><\/td>\n<td>No<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td><b>Insomnia (sleep)<\/b><\/td>\n<td>Yes<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td><b>Nausea (non-surgical)<\/b><\/td>\n<td>Yes<\/td>\n<td>Yes<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 id=\"which-is-better-for-anxiety-or-sleep\"><span style=\"font-weight: 500;\">Which is better for anxiety or sleep?<\/span><\/h2>\n<p>There are currently no head-to-head studies or clinical trials comparing hydroxyzine pamoate versus HCl for anxiety or sleep.<\/p>\n<p>However, the different absorption rate suggests that HCl might be the better option for faster sleep onset. \u201cYou may feel sleepy more quickly with HCl because it\u2019s more quickly absorbed into your system,\u201d Dr. Douglas says. \u201cPamoate gently leads you into sleepiness, but over a longer period of time.\u201d<\/p>\n<p>If you need rapid anxiety relief or sedation before a procedure, a healthcare provider may inject you with hydroxyzine HCl. Hydroxyzine pamoate isn\u2019t available as an injection.<\/p>\n<p><b>Read more: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/hydroxyzine-for-anxiety\/\">Hydroxyzine for anxiety: Does it work?<\/a><\/p>\n<h2 id=\"which-is-better-for-itching\"><span style=\"font-weight: 500;\">Which is better for itching?<\/span><\/h2>\n<p>There\u2019s no definitive evidence that one form of hydroxyzine is better than the other for itching, but emerging research has found that pamoate may have additional activity that can benefit itching. It isn\u2019t known whether this can provide more symptom relief than hydroxyzine HCl. .<\/p>\n<p>In a <a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S0026895X24027780\">2010 report<\/a>, a professor of pharmacology at the University of Michigan noted that pamoate has been shown to activate a certain receptor in the body called GPR35. GPR35 may play a role in immune responses and inflammation.<\/p>\n<p>In 2023, <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/37501600\/\">a group of researchers found<\/a> that pamoate improves itching and skin inflammation through a GPR35-related pathway.<\/p>\n<p>It\u2019s unclear whether hydrochloride (HCl) offers similar benefits.<\/p>\n<h2 id=\"side-effects\"><span style=\"font-weight: 500;\">Side effects<\/span><\/h2>\n<p>Both forms of hydroxyzine carry the same risk of side effects, which may include:<\/p>\n<ul>\n<li>Dry mouth<\/li>\n<li>Drowsiness<\/li>\n<li>Headache<\/li>\n<li>Allergic reaction<\/li>\n<li>A heart rhythm abnormality called QT prolongation<\/li>\n<\/ul>\n<p>In rare cases, hydroxyzine can cause tremors or convulsions, a severe skin reaction called acute generalized exanthematous pustulosis (AGEP). Some people also hallucinate while taking hydroxyzine. \u201cBlurred vision, constipation, and urinary retention can also occur,\u201d Dr. Lyons says.<\/p>\n<p>After receiving an injection of hydroxyzine HCl, a severe injection site reaction can occur in which the tissue becomes damaged, infected, and dies. This may require surgery.<\/p>\n<p>It\u2019s possible to take too much hydroxyzine. A hydroxyzine overdose can look like extreme sedation, convulsions, nausea, vomiting, and stupor.<\/p>\n<p>\u201cYou also need to be careful about taking either form of hydroxyzine with other sedatives, such as pain medications, as they can also make you breathe slower than you should,\u201d says Dr. Douglas.<\/p>\n<p>Talk to a healthcare professional or pharmacist for a full list of potential hydroxyzine side effects.<\/p>\n<table class=\" singlecare-table\" role=\"table\">\n<thead>\n<tr>\n<th colspan=\"3\">\n<h3 id=\"compare-hydroxyzine-pamoate-vs-hydroxyzine-hcl-side-effects\"><span style=\"font-weight: 500;\">\u00a0 \u00a0Compare hydroxyzine pamoate vs. hydroxyzine HCl side effects<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"header-row\">\n<td><b>Side effect<\/b><\/td>\n<td><b>Hydroxyzine pamoate<\/b><\/td>\n<td><b>Hydroxyzine HCl<\/b><\/td>\n<\/tr>\n<tr>\n<td><b>Drowsiness\/sedation<\/b><\/td>\n<td>Common<\/td>\n<td>Common<\/td>\n<\/tr>\n<tr>\n<td><b>Dry mouth<\/b><\/td>\n<td>Possible<\/td>\n<td>Possible<\/td>\n<\/tr>\n<tr>\n<td><b>Headache<\/b><\/td>\n<td>Possible<\/td>\n<td>Possible<\/td>\n<\/tr>\n<tr>\n<td><b>Tremors, convulsions<\/b><\/td>\n<td>Serious, rare<\/td>\n<td>Serious, rare<\/td>\n<\/tr>\n<tr>\n<td><b>QT prolongation (serious, rare)<\/b><\/td>\n<td>Serious, rare<\/td>\n<td>Serious, rare<\/td>\n<\/tr>\n<tr>\n<td><b>Allergic reaction or rash<\/b><\/td>\n<td>Serious, rare<\/td>\n<td>Serious, rare<\/td>\n<\/tr>\n<tr>\n<td><b>Injection site reaction<\/b><\/td>\n<td>N\/A<\/td>\n<td>Can be severe, rare<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 id=\"drug-interactions-and-warnings\">Drug interactions and warnings<\/h2>\n<p>Hydroxyzine HCl and pamoate have identical drug interactions and warnings.<\/p>\n<p>Tell your prescriber about all other medications and supplements you\u2019re taking so they can check for potential drug interactions. It shouldn\u2019t be taken by people who have a prolonged QT interval or who have previously been sensitive to hydroxyzine, cetirizine, or levocetirizine.<\/p>\n<p>You should also tell your prescriber if you\u2019re pregnant or planning to become pregnant. Hydroxyzine should not be taken in early pregnancy or while breastfeeding.<\/p>\n<p>Your prescriber may need to adjust the dose of any opioids you take while taking hydroxyzine. Hydroxyzine increases the sedative effects of opioid medications. Note that <a href=\"https:\/\/www.singlecare.com\/blog\/is-hydroxyzine-addictive\/\">hydroxyzine isn\u2019t addictive<\/a>, but its sedating effects can lead to misuse.<\/p>\n<h2 id=\"insurance-coverage-and-cost\"><span style=\"font-weight: 500;\">Insurance coverage and cost<\/span><\/h2>\n<p>Because hydroxyzine is a generic and low-cost medication, insurance companies tend to cover it without issue. You can double-check insurance coverage by contacting your insurance provider, healthcare provider, or pharmacist.<\/p>\n<p>If you need to pay out of pocket, you\u2019ll find both forms of hydroxyzine tend to be affordable.<\/p>\n<ul>\n<li>Generic hydroxyzine HCl costs an average of $33 for 30, 25 mg tablets without insurance or discounts.<\/li>\n<li>Generic hydroxyzine pamoate costs an average of $24 for 30, 25 mg capsules without insurance or discounts.<\/li>\n<\/ul>\n<p>Note: Because hydroxyzine is usually taken as needed up to four times per day, thirty tablets or capsules could last one week or longer.<\/p>\n<p>A free SingleCare coupon can lower the cost of hydroxyzine even more.<\/p>\n<ul>\n<li>Generic <a href=\"https:\/\/www.singlecare.com\/prescription\/hydroxyzine-hcl\">hydroxyzine HC<\/a>l costs as low as $5 for 30, 25 mg tablets with a SingleCare coupon.<\/li>\n<li>Generic <a href=\"https:\/\/www.singlecare.com\/prescription\/hydroxyzine-pamoate\">hydroxyzine pamoate<\/a> costs as low as $5 for 30, 35 mg capsules with a SingleCare coupon.<\/li>\n<\/ul>\n<p>SingleCare discounts can\u2019t be combined with insurance, so they won\u2019t count toward your deductible. The final price may vary based on form, quantity, and pharmacy.<\/p>\n<table class=\" singlecare-table\" role=\"table\">\n<thead>\n<tr>\n<th colspan=\"3\">\n<h3 id=\"compare-hydroxyzine-pamoate-vs-hydroxyzine-hcl-coverage-and-cost\"><span style=\"font-weight: 500;\">\u00a0 \u00a0Compare hydroxyzine pamoate vs. hydroxyzine HCl coverage and cost<\/span><\/h3>\n<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr class=\"header-row\">\n<td><b>Coverage and cost<\/b><\/td>\n<td><b>Hydroxyzine pamoate<\/b><\/td>\n<td><b>Hydroxyzine HCl<\/b><\/td>\n<\/tr>\n<tr>\n<td><b>Typically covered by insurance?<\/b><\/td>\n<td>Yes<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td><b>Typically covered by Medicare Part D?<\/b><\/td>\n<td>Yes<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td><b>Typically covered by Medicaid?<\/b><\/td>\n<td>Varies by state<\/td>\n<td>Varies by state<\/td>\n<\/tr>\n<tr>\n<td><b>Brand available?<\/b><\/td>\n<td>Yes (Vistaril)<\/td>\n<td>No (Discontinued)<\/td>\n<\/tr>\n<tr>\n<td><b>Generic available?<\/b><\/td>\n<td>Yes<\/td>\n<td>Yes<\/td>\n<\/tr>\n<tr>\n<td><b>SingleCare price<\/b><\/td>\n<td>$5.47 for 30, 25 mg capsules at Kroger<\/td>\n<td>$4.95 for 30, 25 mg tablets at Walmart<\/td>\n<\/tr>\n<tr>\n<td><b>Get coupon<\/b><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/hydroxyzine-pamoate\">Get coupon<\/a><\/td>\n<td><a class=\"cta-button\" href=\"https:\/\/www.singlecare.com\/prescription\/hydroxyzine-hcl\">Get coupon<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 id=\"bottom-line\"><span style=\"font-weight: 500;\">Bottom line<\/span><\/h2>\n<p>Hydroxyzine HCl and hydroxyzine pamoate are equally effective. You shouldn\u2019t notice a difference in side effects or overall performance. Hydroxyzine HCl is also the only version that can be taken as a syrup or intramuscular injection, so it may work better for people who struggle to take pills or capsules.<\/p>\n<p>A healthcare provider can recommend the right version of hydroxyzine for you. If you can\u2019t take this medication due to hypersensitivity or a contraindication, ask your healthcare provider about <a href=\"https:\/\/www.singlecare.com\/blog\/hydroxyzine-alternatives\/\">hydroxyzine alternatives<\/a>.<\/p>\n<h2 id=\"frequently-asked-questions\"><span style=\"font-weight: 500;\">Frequently asked questions<\/span><\/h2>\n<h3 id=\"is-hydroxyzine-pamoate-the-same-as-hydroxyzine-hcl\"><span style=\"font-weight: 500;\">Is hydroxyzine pamoate the same as hydroxyzine HCl?<\/span><\/h3>\n<p>Hydroxyzine pamoate and hydroxyzine HCl contain the same active ingredient (hydroxyzine), but they are different salt forms. They\u2019re extremely similar, but hydroxyzine HCl is water-soluble and hydroxyzine pamoate isn\u2019t.<\/p>\n<h3 id=\"is-atarax-a-controlled-substance\"><span style=\"font-weight: 500;\">Is Atarax a controlled substance?<\/span><\/h3>\n<p>No, Atarax (a brand name for hydroxyzine HCl that has been discontinued) is not a controlled substance.<\/p>\n<h3 id=\"is-hydroxyzine-over-the-counter\"><span style=\"font-weight: 500;\">Is hydroxyzine over the counter?\u00a0<\/span><\/h3>\n<p>No, hydroxyzine is not available over the counter. It requires a prescription.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Hydroxyzine, a common anti-anxiety and antihistamine prescription medication, comes in two forms: hydrochloride (HCl) and pamoate. They both contain the same active drug, but they have different salt forms (pamoate vs. hydrochloride).\u00a0 There are virtually no other established differences between hydroxyzine pamoate versus. HCl, but recent studies suggest pamoate may provide an extra boost for [&hellip;]<\/p>\n","protected":false},"author":133,"featured_media":629513,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8313],"tags":[554,9777],"coauthors":[21074],"class_list":["post-629512","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-drug-vs-drug","tag-allergies","tag-anxiety","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.0 (Yoast SEO v28.0) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Hydroxyzine pamoate vs. HCl: Key differences<\/title>\n<meta name=\"description\" content=\"Hydroxyzine pamoate and HCl contain the same active ingredient but differ in absorption and available forms. 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