Hydroxyzine
Is It Right for You?
A complete guide to Hydroxyzine — what it treats, how it works, dosages, side effects, and when a clinician may prescribe it following an online consultation.
What Is Hydroxyzine?
Hydroxyzine is a sedating antihistamine used to relieve the symptoms of anxiety, to help with itching, and sometimes as a short-term aid for difficulty sleeping. It has a calming effect as well as blocking histamine.
It is taken as a tablet or liquid, usually a few times a day or at night, and works fairly quickly. It is available generically and under brand names such as Atarax and Ucerax.
Hydroxyzine is a prescription-only medication in the UK. A licensed clinician must review your symptoms and medical history before it can be prescribed - which can now be done conveniently through a telehealth consultation.
What Conditions Is Hydroxyzine Used For?
Hydroxyzine is prescribed for:
providing short-term relief of anxiety and the tension or restlessness that comes with it.
easing itching caused by allergic conditions such as hives and eczema.
occasionally used short term to help with sleep, partly because of its sedating effect.
sometimes used to relax and sedate before certain medical or dental procedures.
Hydroxyzine commonly causes drowsiness. Do not drive or operate machinery until you know how it affects you, and avoid alcohol, which increases this effect.
How Does Hydroxyzine Work?
Hydroxyzine is an antihistamine. It blocks histamine, a chemical involved in allergic reactions and itching, which is how it relieves hives and other allergic skin symptoms.
Because hydroxyzine crosses into the brain, it also has a calming, sedating effect. This is thought to underlie its usefulness in anxiety and as a short-term sleep aid, by dampening activity in parts of the brain involved in alertness.
Unlike many anxiety medicines, hydroxyzine is not a benzodiazepine and is not considered addictive, which is one reason it may be chosen for short-term anxiety relief.
Dosages & Administration
The correct dose depends on the type and severity of infection, age, weight, and kidney function. Always follow your clinician's instructions. The table below is for general reference only.
Administration Tips
Take as prescribed, often with a larger dose at night to make use of the sedating effect when itching or sleep is the problem.
Avoid alcohol and other sedating medicines, which add to drowsiness and slowed reactions.
Side Effects of Hydroxyzine
Drowsiness is the most common effect. Most side effects are mild and dose-related.
- Drowsiness or sleepiness
- Dry mouth
- Headache
- Tiredness
- Blurred vision
- Constipation
- Fast or irregular heartbeat (palpitations)
- Fainting
- Severe allergic reaction
- Difficulty passing urine
- Severe skin reaction with blistering
Hydroxyzine can affect the heart's electrical rhythm (QT interval). It is avoided in people with certain heart conditions or those taking other medicines that affect heart rhythm. Tell your clinician about any heart problems.
Drug Interactions
Always disclose all prescription drugs, over-the-counter medicines, vitamins, and supplements to your clinician or pharmacist before starting hydroxyzine.
Combining hydroxyzine with other QT-prolonging drugs increases the risk of dangerous heart rhythm changes and is usually avoided.
Alcohol, sleeping tablets, and strong painkillers add to drowsiness and slowed reactions.
Taking more than one sedating antihistamine increases drowsiness and side effects such as dry mouth.
These can intensify the anticholinergic and sedating effects of hydroxyzine.
Combining with other drugs that cause dry mouth and constipation can worsen these effects.
Important Warnings
Hydroxyzine can prolong the QT interval and is not suitable for people with certain heart rhythm problems or a family history of sudden cardiac death. Tell your clinician about any heart concerns.
Older people are more sensitive to drowsiness, confusion, and falls. Lower doses are used, and the medicine is generally for short-term use only.
Because it causes drowsiness, hydroxyzine can impair driving and the use of machinery. Do not drive until you know how it affects you.
Hydroxyzine is generally avoided in pregnancy, especially near delivery, and passes into breast milk. Tell your clinician if you are pregnant, planning pregnancy, or breastfeeding.
Speak to a Clinician About Treatment
Getting advice no longer means sitting in a waiting room. Through The GP Service, you can consult with a licensed clinician in minutes — from home, on your lunch break, or wherever works for you. If treatment is clinically appropriate, your clinician can issue a prescription during the consultation. A consultation does not guarantee a prescription.
The treatment you need, when you need it.
Hydroxyzine FAQs
Yes. A licensed clinician can review your symptoms and medical history through a telehealth consultation and prescribe hydroxyzine if it is clinically appropriate.
No. Hydroxyzine is an antihistamine, not a benzodiazepine, and is not considered habit-forming, which is one reason it may be used for short-term anxiety relief.
Hydroxyzine usually starts to work within an hour or so, with its calming and sedating effects felt fairly soon after a dose.
It can, especially at higher or night-time doses. If you feel drowsy in the morning, do not drive and tell your clinician, as the dose or timing may need adjusting.
No - alcohol significantly increases drowsiness and slows your reactions while taking hydroxyzine. It is best avoided.
Take it when you remember unless it is almost time for the next dose, in which case skip it. Do not take a double dose.
Hydroxyzine is generally intended for short-term use. If anxiety is ongoing, your clinician can discuss longer-term treatments and talking therapies.