Hydroxyzine Insights
Oral Hydroxyzine side effects: Strategies for Managing Their Impact
Hydroxyzine (Vistaril) is a generic* prescription medication utilized in adults and certain children for various purposes:
- managing anxiety
- alleviating itching caused by certain conditions, such as allergies and eczema
- facilitating sedation (a state of relaxation and sleepiness) before or after anesthesia administration for a medical procedure
Hydroxyzine is available in various forms, including oral tablets, oral capsules, oral syrup, and injectable solutions. This discussion primarily focuses on the oral tablet and capsule varieties. For information on other forms, consult your doctor.
Hydroxyzine can be prescribed for short-term or long-term use. Like other medications, hydroxyzine may have side effects.
Continue reading to explore potential common, mild, and serious side effects. To gain a general understanding of hydroxyzine, including its uses, refer to this article. Your physician can provide additional information.
Hydroxyzine: More Common Side Effects
Hydroxyzine may cause various side effects, some more frequent than others. These side effects could be temporary, lasting a few days to weeks. If they persist longer or become bothersome, speak with your doctor or pharmacist.
Below are a few reported common side effects from hydroxyzine tablets and hydroxyzine capsules trials:
- drowsiness
- headache*
- dry mouth*
Hydroxyzine: Mild Side Effects
Mild side effects may occur with hydroxyzine use. The following list does not include all possible mild side effects of the drug. For more information, consult the prescribing information for hydroxyzine tablets and hydroxyzine capsules.
Mild side effects reported with hydroxyzine include:
- drowsiness
- hives
- itching
- skin rash
- constipation
- fatigue
- weakness
- low blood pressure
- headache*
- dry mouth*
- mild allergic reaction*
These side effects may be temporary, lasting a few days to weeks. If they persist longer or become bothersome, reach out to your doctor or pharmacist.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects. If you experience a side effect while taking hydroxyzine and want to report it to the FDA, visit MedWatch.
Hydroxyzine: Serious Side Effects
Hydroxyzine may cause severe side effects. The list below may not include all possible serious side effects of the drug. For more information, consult the prescribing information for hydroxyzine tablets and hydroxyzine capsules.
If you develop serious side effects while taking hydroxyzine, contact your doctor immediately. If the side effects seem life-threatening or you think you're having a medical emergency, call 911 or your local emergency number right away.
Serious side effects reported and their symptoms include:
- Convulsions or tremors. Symptoms may include:
- involuntary and uncontrollable muscle movements
- shaking in various body parts, such as the head, arms, or legs
- Severe skin reactions, such as acute generalized exanthematous pustulosis (a rare skin condition). Symptoms may include:
- severe rash
- skin discoloration
- pustules
- Long QT syndrome (a type of abnormal heart rhythm), which may lead to a serious condition called torsades de pointes. Symptoms may include:
- dizziness
- fainting
- heart palpitations
- Hallucinations.*
- Severe allergic reaction.†
Hydroxyzine: FAQs About Side Effects
Hydroxyzine may cause several side effects. Below are some frequently asked questions about the drug’s side effects and their answers.
How do the side effects of hydroxyzine HCl oral tablets compare with hydroxyzine pamoate oral capsules?
The side effects of hydroxyzine are expected to be the same regardless of the form you take.
Hydroxyzine comes as an oral tablet, which is called hydroxyzine hydrochloride (sometimes abbreviated as hydroxyzine HCl). The drug also comes as an oral capsule called hydroxyzine pamoate. Throughout this article, the term “hydroxyzine” is used to describe the drug's tablet and capsule forms.
For lists of possible side effects from hydroxyzine tablets and capsules, see the “Hydroxyzine: Mild side effects” and “Hydroxyzine: Serious side effects” sections above.
Does hydroxyzine cause different side effects in women versus men?
Most side effects of hydroxyzine are expected to be the same for females and males who take the drug.
However, hydroxyzine may cause specific side effects in females who are pregnant or breastfeeding. For details, see the “Hydroxyzine: Precautions” section below.
If you have questions about your risk of certain side effects from hydroxyzine, talk with your doctor or pharmacist.
Is weight gain a side effect of hydroxyzine?
No, hydroxyzine is not known to cause weight gain. This was not reported as a side effect in clinical trials of hydroxyzine tablets or hydroxyzine capsules.
If you're worried about weight variations while using hydroxyzine, it's best to consult your physician. They can provide advice on maintaining a weight that's ideal for you, given your specific health situation.
Is hydroxyzine's effect on side effects influenced by the condition it's being used to treat, such as anxiety?
Generally speaking, hydroxyzine's side effects aren't expected to vary significantly based on the condition it's being used for. For instance, the side effects of hydroxyzine should be roughly the same when it's used for sleep aid or to manage anxiety.
For further details on potential side effects, check out the "Hydroxyzine: Mild side effects" and "Hydroxyzine: Serious side effects" sections above.
Is hydroxyzine more likely to cause certain side effects in older adults (65 years and above)?
Yes, hydroxyzine might induce specific side effects in older adults. For example, hydroxyzine can lead to confusion and severe drowsiness in individuals aged 65 years and above. Older adults may also have a higher susceptibility to certain hydroxyzine side effects, such as dry mouth and constipation. Due to these potential issues, doctors might prescribe a lower hydroxyzine dose for older adults.
Keep in mind that older adults might have underlying health conditions that could impact how their bodies process hydroxyzine, such as liver and kidney problems, which could potentially heighten the risk of side effects.
If you have concerns about your risk of side effects due to your age, talk to your doctor.
Does hydroxyzine lead to long-term side effects?
It's unlikely that hydroxyzine will result in prolonged side effects. The drug's side effects usually subside within hours or days of starting or discontinuing therapy. No long-term side effects were mentioned in clinical trials of hydroxyzine tablets or hydroxyzine capsules.
Long-term side effects can refer to either:
- side effects that emerge during treatment and persist for an extended period, even after therapy has ended
- side effects that develop after prolonged usage of the drug
If you have questions about hydroxyzine and its long-term side effects, speak to your doctor.
Hydroxyzine: Side effect details
Learn more about some of the side effects that hydroxyzine might cause. For information about the frequency of these side effects in clinical trials, refer to the prescribing information for hydroxyzine tablets and hydroxyzine capsules.
Headache
A headache may occur with hydroxyzine. The actual prevalence of this side effect in clinical trials for hydroxyzine tablets and hydroxyzine capsules is unclear.
Headaches while under hydroxyzine treatment are usually mild and tend to resolve within hours or days of starting or ending treatment.
What you can do
If a bothersome or persistent headache occurs during hydroxyzine treatment, contact your doctor. They might recommend strategies to alleviate this side effect, such as suggesting an over-the-counter pain reliever like naproxen (Aleve) or ibuprofen (Advil).
Dry mouth
Dry mouth might occur with hydroxyzine use. The prevalence of this side effect in clinical trials for hydroxyzine tablets and hydroxyzine capsules is unknown.
Symptoms of dry mouth can include:
- bad breath
- increased thirst
- stringy or sticky saliva
What you can do
If you experience dry mouth while taking hydroxyzine, consult your doctor. They might suggest approaches to ease this side effect. For example, they may advise you to avoid foods or drinks that could worsen dry mouth, like extremely hot or cold beverages. You can also browse this article for additional remedies for dry mouth.
Hallucinations
Hydroxyzine might trigger hallucinations. However, it's uncertain how often this side effect was reported in clinical trials for hydroxyzine tablets and hydroxyzine capsules.
Hallucinations involve experiencing something that isn't real, such as seeing, hearing, smelling, tasting, or feeling sensations that aren't actually present.
What you can do
If you hallucinate while taking hydroxyzine, talk with your doctor. They will likely suggest switching you to a different medication to manage your condition.
Allergic reaction
Like many drugs, hydroxyzine can induce an allergic reaction in some individuals. Yet, it's unclear whether this side effect was reported in clinical trials for hydroxyzine tablets and hydroxyzine capsules. It should be noted that allergic reactions have been reported since hydroxyzine was approved for use.
Symptoms can range from mild to severe and might include:
- skin rash
- itching
- flushing
- swelling under your skin, typically in areas like your eyelids, lips, hands, or feet
- swelling of your mouth, tongue, or throat, which can make it difficult to breathe
What you can do
For mild symptoms of an allergic reaction, contact your doctor immediately. They may provide suggestions to alleviate your symptoms and determine whether you should continue taking hydroxyzine. However, if your symptoms are serious and you believe you're experiencing a medical emergency, call 911 or your local emergency number right away.
Cardiac issues. See to it that you inform your physician about any heart issues prior to consuming hydroxyzine. Examples include irregular heartbeats, heart failure causing symptoms, or a recent heart attack. Having any of these heart problems may enhance your risk of developing long QT syndrome (a type of abnormal heartbeat) as a side effect of the drug. If you have a heart issue, your doctor can advise whether hydroxyzine is a safe treatment option for you.
Advanced age. Doctors generally avoid prescribing hydroxyzine to individuals aged 65 and above unless there aren't any alternative treatments. This is due to older adults having a higher risk of certain side effects, such as constipation, drowsiness, and dry mouth, when taking hydroxyzine. Older adults are often given a lower dose, and their doctor will closely monitor them for side effects.
Dementia. Hydroxyzine can induce side effects, including confusion and difficulty concentrating. Individuals with dementia may have a higher risk of these side effects if they take hydroxyzine. If you have dementia, your doctor will try to recommend a different treatment whenever possible.
Renal or hepatic problems. After ingesting hydroxyzine, your kidneys and liver break down and eliminate the drug. If you have a kidney or liver issue, your body may not break down hydroxyzine as efficiently. This could lead to an elevated drug level in your body, increasing your risk of side effects. Your doctor can decide whether hydroxyzine is safe for you based on the severity of your kidney or liver issues.
Seizures or convulsions. Rarely, seizures have been reported as a side effect with hydroxyzine use. Most cases seem to be due to taking hydroxyzine doses higher than recommended. The drug hasn't been studied in people with seizure disorders, such as epilepsy, so it's unclear whether taking hydroxyzine could worsen your seizures or convulsions. Consult your doctor to discuss the safety of hydroxyzine for you.
Allergic reactions. If you've had an allergic response to hydroxyzine or any of its components, your doctor is unlikely to prescribe hydroxyzine. Taking hydroxyzine could cause you to have another allergic reaction. Consult your doctor about alternative medications.
Alcohol and hydroxyzine
Avoid consuming alcohol while taking hydroxyzine. Combining the two can intensify drowsiness, a side effect of hydroxyzine.
If you have questions about alcohol consumption while taking hydroxyzine, talk to your doctor.
Pregnancy and breastfeeding while using hydroxyzine
Hydroxyzine should not be taken during pregnancy or while breastfeeding. Clinical trials have not studied the use of hydroxyzine tablets and capsules in pregnant or breastfeeding individuals.
It's possible that hydroxyzine may lead to side effects in a child born to a person who took hydroxyzine during pregnancy. If you breastfeed while taking hydroxyzine, it's also possible that this could cause side effects in your child.
Your doctor is unlikely to prescribe hydroxyzine if you are pregnant or breastfeeding. They can suggest an alternative treatment for your condition during these periods.
Consult your doctor
Both minor and serious side effects may occur with hydroxyzine. However, most of the drug's side effects are expected to be mild. If you experience side effects that persist or are bothersome, talk to your doctor or pharmacist.
If you'd like to learn more about hydroxyzine, talk to your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug. You can also ask them about Vistaril, the brand-name version of hydroxyzine capsules.
A generic drug and its brand-name version contain the same active ingredient, so they're expected to have the same side effects. Referring to the following articles about hydroxyzine can provide you with additional information:
- More information about hydroxyzine. For details about other aspects of hydroxyzine, refer to this article.
- Cost. If you'd like to learn about hydroxyzine and cost, see this article.
- Your condition. For details about your condition, see our:
- anxiety hub
- allergy hub
- eczema hub
- dermatology hub
Disclaimer:Medical News Today has made every effort to ensure that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.
- For individuals struggling with mental health issues, it's important to note that long-term use of drugs like hydroxyzine may exacerbate underlying conditions such as anxiety or develop atopic dermatitis, a type of eczema. Consult with your doctor for alternative treatment options.
- Prescription medications, including hydroxyzine, may interact with over-the-counter drugs or even certain foods. While using hydroxyzine, it's crucial to avoid taking any medications containing dextromethorphan, an ingredient commonly found in cold and cough remedies, as this can increase the risk of severe side effects.
- Individuals with a history of substance abuse are at a higher risk of dependence on medications used for anxiety, such as hydroxyzine. If you have a history of substance abuse, it's essential to discuss this with your doctor before beginning treatment to ensure the most suitable course of action.
