Hydroxyzine Tablets Guide: Uses, Dosage & Side Effects
Hydroxyzine tablets: Effective relief for itching and urticaria with key usage and safety information.
Peer reviewed. Last updated 27 Apr 2023. Meets editorial guidelines.
About hydroxyzine
| Type of medicine | An antihistamine |
|---|---|
| Used for | Itching, urticaria |
| Available as | Tablets |
Hydroxyzine belongs to a group of medicines known as sedating antihistamines. It is primarily used to relieve itching caused by various skin conditions, such as nettle rash (urticaria) or allergic reactions. By blocking histamine, a substance released during allergic responses, hydroxyzine effectively reduces symptoms like itching, hives, and related discomfort. Unlike non-sedating antihistamines, hydroxyzine crosses the blood-brain barrier, leading to sedative effects that can aid sleep but also cause drowsiness.
The medication is rapidly absorbed from the gastrointestinal tract, with peak plasma concentrations reached in about 2 hours and a duration of action lasting 4-6 hours. Its half-life varies: approximately 20 hours in adults, shorter in children (around 7 hours), and longer in the elderly (up to 29 hours) or those with renal/hepatic impairment. Hydroxyzine hydrochloride is commonly available as tablets, syrups, or injections, while hydroxyzine pamoate comes in capsules, with similar efficacy but differing costs and forms.
Beyond itching, hydroxyzine is used for anxiety, tension, sedation before/after surgery, and sometimes nausea or motion sickness in palliative care settings. However, for standard use in itching, it targets histaminic edema, flare, and pruritus via potent inverse agonism at H1-receptors.
Before taking hydroxyzine
Some medicines are not suitable for people with certain conditions, and sometimes a medicine can only be used if extra care is taken. For these reasons, before you start taking hydroxyzine it is important that your doctor or pharmacist knows:
- Whether you are pregnant, trying for a baby or breastfeeding. Hydroxyzine is not usually recommended in pregnancy unless essential, and it passes into breast milk.
- If you have a problem with the way your liver works, or if you have a problem with your kidneys. Dose adjustments may be needed due to prolonged half-life.
- If you have a condition which causes increased pressure in your eyes, such as glaucoma.
- If you have prostate problems, or if you have been experiencing any difficulty passing urine.
- If you know you have an unusual heart rhythm. Hydroxyzine can prolong the QT interval, increasing risk of arrhythmias like Torsade de Pointes, especially with risk factors or concomitant drugs.
- If you know you have a blockage in your small intestines.
- If you have epilepsy, as it may lower the seizure threshold.
- If you have any allergies, including to other antihistamines.
Additionally, inform your doctor of all other medications, as hydroxyzine potentiates CNS depressants (e.g., alcohol, opioids, anesthetics) and may interact with QT-prolonging drugs. It is generally not recommended for children under 6 months or elderly patients with fall risk due to sedation.
How to take hydroxyzine
Before you start this treatment, read the manufacturer’s printed information leaflet from inside your pack. The manufacturer’s leaflet will give you more information about hydroxyzine and will provide a full list of the side-effects which you may experience from taking it.
Take hydroxyzine exactly as your doctor tells you to. Usually, it is sufficient to take one dose at night to control symptoms. Where this is not the case, you may be asked to take 2 or 3 doses during the day in addition to your dose at night. Common adult doses for itching are 25 mg up to three times daily; for anxiety, 50-100 mg up to four times daily; children doses are weight-based (e.g., 0.5-1 mg/kg/day).
You can take hydroxyzine before or after food. Some people find it helps to swallow the tablets with a drink of water. Tablets are available in 10 mg, 25 mg strengths; syrup for precise pediatric dosing.
If you forget to take a dose, don’t worry, just take the next dose when it is due and then continue as before. Do not take two doses together to make up for a forgotten dose.
Most people only need to take an antihistamine for a short while when they have symptoms. You should stop taking hydroxyzine once your symptoms have eased. Treatment duration is typically short-term to avoid tolerance or dependence on sedative effects.
Can hydroxyzine cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. The table below contains the most common ones associated with hydroxyzine. You will find a full list in the manufacturer’s information leaflet supplied with your medicine. The unwanted effects often improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any continue or become troublesome.
| Common side-effects | What can I do if I experience this? |
|---|---|
| Feeling dizzy or sleepy, blurred vision | Do not drive and do not use tools or machines. Do not drink alcohol. Effects onset 15-60 min, last 4-6 hrs |
| Headache | Drink plenty of water and ask your pharmacist to recommend a suitable painkiller. If headaches continue, let your doctor know |
| Dry mouth | Try sucking sugar-free sweets or chewing sugar-free gum |
| Constipation, nausea | Eat fiber-rich foods, stay hydrated; take with food if stomach upset |
Rare but serious effects include QT prolongation (monitor ECG in at-risk patients), seizures, severe allergic reactions, urinary retention, or confusion (especially in elderly). Post-marketing data confirms cardiac risks, prompting EMA updates to product info. Overdose can cause extreme drowsiness, seizures, or coma—seek emergency help.
How to store hydroxyzine
Keep all medicines out of the reach and sight of children. Store in a cool, dry place away from direct heat and light. Do not use hydroxyzine after the expiry date which is stated on the pack. Disposal: return unused medicine to pharmacist for safe destruction.
Further information and support
For more information, speak to your doctor, pharmacist, or nurse. Patient.info provides reliable, evidence-based health information. Downloadable PDF available for printing.
Frequently Asked Questions (FAQs)
Q: What is hydroxyzine used for?
A: Primarily for relieving itching from urticaria or allergies; also anxiety, sedation, nausea.
Q: Does hydroxyzine make you sleepy?
A: Yes, drowsiness is the most common side effect due to its sedating properties.
Q: Can I drink alcohol with hydroxyzine?
A: No, it enhances drowsiness and CNS depression.
Q: Is hydroxyzine safe in pregnancy?
A: Not usually recommended; consult doctor.
Q: How long does hydroxyzine take to work?
A: 15-60 minutes for onset, effects last 4-6 hours.
Q: What if I miss a dose?
A: Take next dose as scheduled; do not double up.
This article provides comprehensive guidance on hydroxyzine tablets, ensuring safe and effective use. Always follow professional medical advice.
References
- Hydroxyzine (Atarax, Ucerax) | Medicine – Patient.info — Patient.info. 2023-04-27. https://patient.info/medicine/hydroxyzine-tablets
- Hydroxyzine in Hospice and Palliative Care — PDC Rx. N/A. https://www.pdcrx.com/articles/hydroxyzine-in-hospice-and-palliative-care-an-in-depth-exploration-and-key-considerations
- Hydroxyzine: Uses, Interactions, Mechanism of Action — DrugBank. N/A. https://go.drugbank.com/drugs/DB00557
- Hydroxyzine: MedlinePlus Drug Information — MedlinePlus (NIH). N/A. https://medlineplus.gov/druginfo/meds/a682866.html
- Hydroxyzine (Atarax® or Vistaril®): Important Patient Information — URMC. N/A. https://www.urmc.rochester.edu/medialibraries/urmcmedia/medicine/general-medicine/patientcare/documents/hydroxyzine_brochure_urmc.pdf
- Hydroxyzine – referral — European Medicines Agency (EMA). N/A. https://www.ema.europa.eu/en/medicines/human/referrals/hydroxyzine
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