Hydroxyzine pamoate is a generic prescription antihistamine that has powerful sedative and calming properties in addition to its ability to reduce allergy symptoms. Healthcare providers primarily use it to treat anxiety, though it’s also FDA-approved to relieve itching or provide sedation before or after anesthesia. In any context, the most relevant side effects are sleepiness, dizziness, and other impairments. Hydroxyzine pamoate can only be taken as a capsule. Other forms of hydroxyzine, such as tablets, liquid, or injections, are available in a different formulation called hydroxyzine hydrochloride.
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Hydroxyzine Pamoate overview
BRAND NAMES:
Vistaril
Generic Names:
Hydroxyzine pamoate
Uses:
Treats anxiety and itching. It may also be used with anesthesia for medical procedures.
Therapeutic Classes:
Anxiolytic, antihistamine, antipruritic, sedative
Forms:
Capsule
How it’s taken:
By mouth
What is Hydroxyzine Pamoate used for?
Hydroxyzine pamoate is FDA-approved to treat anxiety, including anxiety brought on by medical conditions. It’s also approved to treat itching due to allergies, chronic hives, or eczema (atopic dermatitis). Finally, healthcare providers can use hydroxyzine pamoate right before or right after general anesthesia to calm and sedate patients.
What form(s) does Hydroxyzine Pamoate come in
Capsule
25 mg
50 mg
What are common Hydroxyzine Pamoate doses?
For anxiety:
In adults: 50–100 mg taken four times per day
In children 6 years and older: 50–100 mg per day taken in divided doses
In children younger than 6 years: 50 mg per day taken in divided doses
For pruritus (itching):
In adults: 25 mg taken three or four times per day
In children 6 years and older: 50–100 mg per day taken in divided doses
In children younger than 6 years: 50 mg per day taken in divided doses
As a sedative used before or after following general anesthesia:
In adults: 50–100 mg
In children: 0.6 mg/kg
Common Hydroxyzine Pamoate prescriptions
hydrOXYzine Pamoate
100mg capsulehydrOXYzine Pamoate
25mg capsulehydrOXYzine Pamoate
50mg capsule
How to take Hydroxyzine Pamoate
Your doctor will tell you how much medicine to use. Do not use more than directed.
Swallow the capsule whole. Do not break, crush, or chew it.
Store the medicine in a closed container at room temperature below 86˚.
What to do if you miss a dose of Hydroxyzine Pamoate
Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose.
Do not take extra medicine to make up for a missed dose.
Hydroxyzine Pamoate contraindications
This medicine is not right for everyone.
Do not use it if you have had an allergic reaction to hydroxyzine, cetirizine, or levocetirizine.
Do not use it during the early part of pregnancy or if you have a heart rhythm problem called prolonged QT interval.
Hydroxyzine Pamoate warnings
Tell any doctor or other healthcare provider who treats you that you are using this medicine.
Doctors may need you to come in for regular office visits to monitor the effects of this drug, particularly in older adults. Keep all appointments.
Tell your doctor if you are pregnant or breastfeeding.
Tell your doctor if you have:
Heart disease
Heart failure
A slow heartbeat
A recent heart attack
Doctors use this medicine cautiously in elderly patients because they may be more vulnerable to side effects and more likely to get hurt because of the sedative effects.
This medicine may cause the following problems:
Changes in your heart rhythm
A serious skin reaction
This medicine may make you drowsy. Do not drive or do anything that could be dangerous until you know how this medicine affects you.
Call your doctor if your symptoms do not improve or if they get worse.
Hydroxyzine Pamoate interactions
To avoid potentially hazardous drug interactions, tell the prescribing healthcare provider about all prescription drugs, over-the-counter medications, and supplements you use before taking hydroxyzine.
Tell other healthcare providers you are using this medicine before they prescribe new medications.
Some medicines can affect how hydroxyzine works or increase the risk of side effects. Alternatively, hydroxyzine can affect how other medicines work or worsen their side effects. Tell your doctor if you are using any of the following:
Certain types of antibiotics called macrolide antibiotics (like azithromycin) or fluoroquinolone antibiotics (like moxifloxacin)
Medications that treat depression
Medications that treat other mental health issues, particularly antipsychotics
Drugs that treat heart rhythm problems
Blood pressure drugs called beta blockers
Anticancer drugs
The antinausea drugs ondansetron or droperidol
The narcotic painkiller methadone
Pentamidine, a drug that treats certain types of infections
Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, barbiturates, narcotic pain medicine, sleep aids, and alcohol.
Do not drink alcohol or use cannabinoid products while taking hydroxyzine.
Find more detailed information about hydroxyzine interactions to avoid here.
Hydroxyzine Pamoate side effects
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
Severe tiredness
Fainting, dizziness, lightheadedness
Skin rash, bumps on the skin, red bumps on the skin
Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
Less serious side effects
Drowsiness
Dizziness
Coordination problems
Dry mouth
Sources:
Hydroxyzine pamoate capsule prescribing information, DailyMed (NIH National Library of Medicine)
Hydroxyzine pamoate drug summary, Prescriber’s Digital Reference (PDR)
Vistaril hydroxyzine pamoate capsule prescribing information, DailyMed (NIH National Library of Medicine)
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