Hydroxyzine is prescribed to relieve symptoms of anxiety or insomnia in adults. It can also be prescribed to treat eczema and other skin conditions.¹

Hydroxyzine is a class of medicines called antihistamines, which prevent the effects of histamines, a substance naturally produced by your body. Preventing the effects of histamines can help control anxiety and tension caused by nervous conditions.²

Hydroxyzine treats sleep issues by decreasing activity in the brain, which helps patients suffering from insomnia, especially anxiety-related insomnia, fall and stay asleep.³

No, hydroxyzine is not considered a controlled substance.⁴

Hydroxyzine is typically taken as-needed for insomnia and either as-needed or on a daily schedule for anxiety. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take hydroxyzine exactly as directed. Do not take more or less of it, or take it more often than prescribed by your doctor.⁵

Symptoms of anxiety can be reduced as early as the first week of treatment. For insomnia, symptoms can improve within 15 to 30 minutes of the first dose of hydroxyzine.⁶

Hydroxyzine stays in your system for about four or five days after your last dose.⁷

RedBox Rx prescribes 25 mg and 50 mg dosages of hydroxyzine for anxiety treatment. Our U.S. licensed medical professionals can help determine the right dosing of hydroxyzine, if prescribed. Start an online consult for anxiety or insomnia to discuss your options.

For sleep, hydroxyzine is usually taken as needed within 15 to 30 minutes before bedtime.

For anxiety, hydroxyzine is either taken as needed, before expected exposure to an anxiety-provoking situation, or it is prescribed to be taken three or four times per day as directed by your doctor. Do not take more or less of it, or take it more often than prescribed by your doctor.^8,9

Hydroxyzine and Xanax® have both demonstrated effectiveness for anxiety, but they treat the issue in different ways. Read our blog Hydroxyzine vs. Xanax for Anxiety: How Do They Compare? to learn about the differences.

There are a variety of different options for sleep medication. Read our blog Prescription Sleep Medications Guide: Trazodone, Hydroxyzine, Mirtazapine and More for help determining what’s best for you.

For anxiety treatment, hydroxyzine is $20 per month. For insomnia treatment, hydroxyzine is $20 per month or $18.33 per month if you purchase a three-month supply from RedBox Rx. No insurance required and no membership fees. We’re able to offer low prices because we purchase hydroxyzine directly from manufacturers and ship from our pharmacy in Iowa.

Our online consultation for anxiety or insomnia costs only $35.

Yes, hydroxyzine expires. Check the expiration date on your bottle and always properly dispose of unused expired medication.

A small portion of people report some weight gain, but this is not common.¹⁰

If you plan to drink alcohol while taking hydroxyzine, discuss the risks with your doctor. Alcohol can make the side effects of hydroxyzine worse.¹¹

Hydroxyzine interactions may occur with certain medications listed below. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Bepridil

• Calcium oxybate

• Cisapride

• Dronedarone

• Isocarboxazid

• Levoketoconazole

• Magnesium oxybate

• Mesoridazine

• Pimozide

• Piperaquine

• Potassium chloride

• Potassium citrate

• Potassium oxybate

• Saquinavir

• Sodium oxybate

• Sparfloxacin

• Terfenadine

• Thioridazine

• Tranylcypromine

• Ziprasidone

Using this medicine with any of the following medicines is usually not recommended but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Adagrasib

• Alfentanil

• Alfuzosin

• Alprazolam

• Amantadine

• Amiodarone

• Amisulpride

• Amitriptyline

• Anagrelide

• Apomorphine

• Aripiprazole

• Aripiprazole lauroxil

• Arsenic trioxide

• Artemether

• Asenapine

• Astemizole

• Atazanavir

• Azithromycin

• Bedaquiline

• Benzhydrocodone

• Bromazepam

• Bromopride

• Buprenorphine

• Bupropion

• Buserelin

• Butalbital

• Butorphanol

• Cannabidiol

• Cannabis

• Carbamazepine

• Carbidopa

• Carbinoxamine

• Ceritinib

• Cetirizine

• Chloroquine

• Chlorpromazine

• Ciprofloxacin

• Citalopram

• Clarithromycin

• Clofazimine

Using this medicine with tizanidine may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.¹²

No, you should not take hydroxyzine while pregnant or while breastfeeding. If you become pregnant while taking hydroxyzine, consult your doctor immediately.¹³

Before taking hydroxyzine (generic Atarax®):¹⁴

• Tell your doctor and pharmacist if you are allergic to hydroxyzine, cetirizine (Zyrtec), levocetirizine (Xyzal) any other medications or any of the ingredients in hydroxyzine preparations. Ask your doctor or pharmacist for a list of the ingredients.

• Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: antihistamines; azithromycin (Zithromax, Zmax), certain antidepressants such as citalopram (Celexa) and fluoxetine (Prozac, Sarafem, Selfemra); medications for anxiety; certain medications for arrhythmias such as amiodarone (Cordarone, Nexterone, Pacerone, procainamide, quinidine (in Nuedexta) and sotalol (Betapace, Sorine, Sotylize); barbiturates; clarithromycin (Biaxin, in Prevpac); droperidol (Inapsine); erythromycin (Eryc, Ery-Tab, PCE, others); gatifloxacin; certain medications for mental illness such as chlorpromazine, clozapine (Clozaril, Fazaclo ODT, Versacloz), iloperidone (Fanapt), quetiapine (Seroquel) and ziprasidone (Geodon); methadone (Dolophine, Methadose); moxifloxacin (Avelox); medications for pain; ondansetron (Zofran, Zuplenz); pentamidine (Nebupent, Pentam); and medications for seizures, sedatives, sleeping pills and tranquilizers. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.

• Tell your doctor if you have a prolonged QT interval (a rare heart problem that may cause irregular heartbeat, fainting or sudden death) or if you plan to be pregnant or are pregnant. Your doctor will probably tell you not to take hydroxyzine.

• Tell your doctor if anyone in your family has or has ever had a prolonged QT interval or if you have or have ever had a slow or irregular heartbeat, low blood levels of potassium or magnesium, heart failure, a heart attack or heart disease.

• Tell your doctor if you are breastfeeding. Do not breastfeed while taking hydroxyzine.

• Talk to your doctor about the risks and benefits of taking hydroxyzine if you are 65 years of age or older. Older adults should not usually take hydroxyzine because it is not as safe as other medications that can be used to treat the same condition.

• You should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.

• Ask your doctor about the safe use of alcohol while you are taking this medication. Alcohol can make the side effects of hydroxyzine worse.

Unless your doctor tells you otherwise, continue your normal diet.¹⁵

If your doctor has told you to take hydroxyzine regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.¹⁶

Hydroxyzine may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• Dry mouth

• Confusion (especially in older adults)

• Dizziness

• Headache

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• Unintentional trembling or shaking movements

• Seizures

• Fever

• Rash

• Pus-filled, blister-like sores, or areas of swelling and redness on the skin

Hydroxyzine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).¹⁷

No, hydroxyzine side effects do not typically cause problems sexually.¹⁸

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom).

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

It is important to keep all medication out of sight and reach of children, as many containers (such as weekly pill minders and those for eye drops, creams, patches and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location, out of their sight and reach. Learn more at http://www.upandaway.org.¹⁹

In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help. If the victim has collapsed, had a seizure, has trouble breathing or can't be awakened, immediately call emergency services at 911.

Symptoms of overdose may include sedation and seizures.²⁰

No, studies and trials have not shown hydroxyzine to be addictive.²¹

For most people, stopping hydroxyzine treatment does not lead to rebound anxiety or other withdrawal symptoms. Always speak with your doctor before stopping any prescribed medication.²²

For most people, hydroxyzine will not trigger any withdrawal symptoms.²³

Keep all appointments with your doctor.

Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.²⁴

Hydroxyzine is the generic version of brand names:²⁵

• Atarax®

• Hypam®

• Orgatrax®

• Vistaril®

We offer a variety of prescription medication options for anxiety including:

• Buspirone (Generic Buspar®)

• Citalopram (Generic Celexa®)

• Paroxetine (Generic Paxil®)

• Venlafaxine ER (Generic Effexor XR®)

• Duloxetine (Generic Cymbalta®)

We also prescribe the following medication for insomnia:

• Trazodone (Generic Desyrel®)

• Mirtazapine (Generic Remeron®)

• Ramelteon (Generic Rozerem®)

• Amitriptyline (Generic Elavil®)

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