What is Hydroxyzine: Uses, Warnings & Interactions

Updated May 14, 2025  •  Published Dec 30, 2020

Hydroxyzine HCl is a commonly prescribed generic prescription drug that can help relieve temporary anxiety as well as itching or nausea. It’s a first-generation antihistamine similar to diphenhydramine but isn’t found in over-the-counter allergy products. Because of its risks and side effects, it’s usually prescribed for short-term use only.

Hydroxyzine overview

BRAND NAMES:

  • No brand name versions

Generic Names:

  • Hydroxyzine HCl

Uses:

  • Treats anxiety, itching due to allergies, and nausea and vomiting. Also used as sedation before procedures.

Therapeutic Classes:

  • Antihistamine, anxiolytic, antipruritic, antiemetic, sedative

Forms:

  • Tablet, oral solution (syrup), injection

How it’s taken:

  • By mouth or intramuscular injection

What is Hydroxyzine used for?

Hydroxyzine HCl is used to treat temporary anxiety, worry, and periods of emotional stress. Hydroxyzine can also relieve itching due to hives, allergic reactions, or atopic dermatitis. Hydroxyzine injections are used to relieve nausea and vomiting. Finally, doctors also use hydroxyzine HCl as a sedative before medical procedures or following general anesthesia.

What form(s) does Hydroxyzine come in

  • Tablet

    • 10 mg

    • 25 mg

    • 50 mg

  • Oral solution (syrup)

    • 10 mg/5 mL

  • Injection

    • 25 mg/mL

    • 50 mg/mL

    • 100 mg/mL

What are common Hydroxyzine doses?

  • For anxiety or agitation in adults: 50–100 mg by mouth or IM injection every six hours as needed

  • To relieve itching in adults: 25 mg by mouth every 6–8 hours as needed

    • In children younger than 6 years old: 50 mg daily taken in divided doses

    • In children 6 years of age and older: 50–100 mg daily taken in divided doses

  • For nausea and vomiting in adults: 25–100 mg injection every six to eight hours as needed 

    • In children: 0.5 mg/kg body weight injection

  • For sedation in adults: 25–100 mg injection or 50–100 mg tablet 

    • In children: 0.5 mg/kg body weight injection or 0.6 mg/kg body weight taken orally

Common Hydroxyzine prescriptions

  • hydrOXYzine HCl
    118ml of 10mg/5ml bottle

  • hydrOXYzine HCl
    473ml of 10mg/5ml bottle

  • hydrOXYzine HCl
    10mg tablet

  • hydrOXYzine HCl
    25mg tablet

  • hydrOXYzine HCl
    50mg tablet

  • hydrOXYzine HCl
    1ml of 25mg/ml vial

  • hydrOXYzine HCl
    1ml of 50mg/ml vial

  • hydrOXYzine HCl
    2ml of 50mg/ml vial

How to take Hydroxyzine

  • Your doctor will tell you how much medicine to use. Do not use more than directed.

  • Hydroxyzine can be taken with or without food.

  • Take hydroxyzine tablets or oral solution with a glass of water.

  • You may take this medicine with food to avoid stomach upset.

  • Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.

What to do if you miss a dose of Hydroxyzine

  • A missed dose may be taken when remembered unless it’s almost time for the next dose. If that’s the case, skip the missed dose and take the next dose as scheduled.

  • Do not take an extra dose to make up for a missed dose.

  • If hydroxyzine is prescribed on an as-needed basis, ask the prescriber about what you should do if you forget a dose.

Hydroxyzine contraindications

  • This medicine is not right for everyone. 

  • Do not use this drug if you have had an allergic reaction to hydroxyzine, cetirizine, or levocetirizine.

  • Hydroxyzine should not be taken by women in the first trimester of a pregnancy.

  • Do not use hydroxyzine if you have a heart rhythm problem called QT prolongation.

Hydroxyzine warnings

  • Tell any doctor or other healthcare provider who treats you that you are using this medicine.

  • Your doctor will check your progress and the effects of this medicine at regular visits. Keep all appointments.

  • Before taking this medication, tell the prescribing healthcare provider if you have:

    • Heart problems or heart rhythm problems

    • Glaucoma or high eye pressure

    • Kidney disease

    • Liver disease

    • Asthma

  • Before taking this medicine, tell your doctor if you are pregnant or planning to get pregnant. Some doctors will not prescribe hydroxyzine to women who are pregnant.

  • Tell the prescriber if you’re breastfeeding or planning to breastfeed.

  • This medicine may cause drowsiness. If it does, avoid driving a car or using machinery.

  • This medicine may cause confusion, excessive sedation, or other side effects in people over 65. Doses may need to be lowered.

  • This medicine may make your skin more sensitive to UV light. Use sunscreen when you are outside, and try not to spend long periods in direct sunlight.

Hydroxyzine interactions

  • Because of possible drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medicines, and supplements you are using before taking this drug.

  • Tell other healthcare providers you are using this medicine before they prescribe new medications.

  • Do not use this medicine together with the antipsychotic medications pimozide and thioridazine. 

  • Do not drink alcohol when taking hydroxyzine.

  • Do not eat grapefruit or drink grapefruit juice when taking hydroxyzine. This may increase hydroxyzine levels in the blood.

  • Make sure your doctor knows if you are taking any medicine that makes you sleepy, such as antihistamines, sedatives, narcotic painkillers, or antidepressants, while you are receiving this medicine.

  • To avoid possible drug interactions, tell your doctor if you also are taking: 

    • Heart rhythm drugs

    • Antidepressants

    • Medications that treat psychosis and other mental health issues called antipsychotic drugs 

    • Opioids

    • Asthma or COPD drugs

    • Antinausea drugs

    • Antibiotics

    • Antifungal drugs

    • HIV drugs

    • Cancer drugs

  • Hydroxyzine syrup may contain alcohol, so it may cause a reaction if you’re on the alcohol abuse medication disulfiram.

Hydroxyzine side effects

Serious side effects

Hydroxyzine can cause serious side effects. Talk to a doctor if you notice any signs or symptoms of a possible serious side effect including:

  • Fast, pounding, or uneven heartbeat, chest pain, severe dizziness

  • Seizures

  • Allergic reaction: Itching, rash, or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing

  • Skin pustules, redness, and swelling

Less serious side effects

  • Drowsiness

  • Dry mouth

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