Hydroxyzine is a commonly prescribed antihistamine medication for anxiety and itchiness due to allergies. It can also work as a sedative before surgery or procedure.
Hydroxyzine is available in two forms: hydroxyzine hydrochloride (the brand name version, Atarax, is no longer available) and hydroxyzine pamoate (brand name Vistaril). Both forms of hydroxyzine are considered to be equivalent to one another.
This is not a comprehensive list of all drugs that may interact with hydroxyzine. Before starting treatment, make sure you share your medication history with your healthcare provider, including all over-the-counter (OTC) or prescription drugs and dietary supplements you are taking.
1. Drugs That Cause Drowsiness
Many drugs, including hydroxyzine, cause drowsiness. This is because these drugs cause a slowing down of thecentral nervous system (CNS), called CNS depression.
Examples of drugs that cause CNS depression include but are not limited to:
The prescribing information for hydroxyzine states that when you take hydroxyzine along with a CNS depressant drug, the effect of CNS depression is stronger. This means the combination could cause extreme sedation, slowed breathing, coma, or even death in rare cases.
Healthcare providers will weigh the risks versus the benefits before prescribing both hydroxyzine and another CNS depressant. If possible, they may avoid the combination. If your healthcare provider feels you cannot avoid the combination, they will likely lower the dose of one or both medicine(s) and monitor the effects closely.
2. Drugs That Affect Heart Rhythm
Certain drugs, including hydroxyzine, can cause an irregular heart rhythm calledQT prolongation.Taking other drugs that also affect heart rhythm increases this risk.
Examples of drugs that may be involved in this interaction include but are not limited to:
Also known aslong QT syndrome, QT prolongation is a heart condition in which the time between two points on an electrocardiogram, called the QT interval, is longer than normal, which means there is a problem with the electrical system that controls the heartbeat.
Hydroxyzine, in rare cases, may also cause a condition called torsades de pointes.
Torsade de pointes is a specific type ofventricular tachycardia(a heart rhythm problem) associated with QT prolongation.This problem generally occurs in people with other risk factors for QT prolongation, such as heart disease, electrolyte problems, or taking certain medicines that can affect the QT interval.
People with prolonged QT intervals should not take hydroxyzine. Also, people with these risk factors, as well as other types of heart problems, family history, or a recent heart attack, should take hydroxyzine with caution.
If there are no risk factors and your healthcare provider prescribes one of the above medications with hydroxyzine, they will closely monitor you.
3. Anticholinergic Drugs
Certain drugs are known asanticholinergic drugsbecause they block a neurotransmitter, or chemical messenger, called acetylcholine.Some examples of anticholinergic drugs include:
Anticholinergic drugs are associated with side effects such as:
Hydroxyzine has an anticholinergic effect, so combining it with another medicine with an anticholinergic effect can result in increased or more severe side effects.
Healthcare providers will avoid the combination when possible. However, if the combination cannot be avoided, they may adjust the dose of one or both medicines and monitor you closely.
4. Alcohol
Alcohol causes CNS depression. Therefore, when taking hydroxyzine, it is also best to avoid drinking alcohol.
If you cannot avoid alcohol, consult your healthcare provider for medical advice before mixing hydroxyzine and alcohol.
Summary
Hydroxyzine is an antihistamine commonly prescribed to treat anxiety or itchiness. It can also act as a sedative before surgeries or procedures. Before you take hydroxyzine, tell your healthcare provider about all your medications, including prescription and OTC drugs, vitamins, and supplements.
Hydroxyzine interacts with certain medicines, such as drugs that cause drowsiness, medicines that affect heart rhythm, and anticholinergic drugs. It is best to avoid alcohol while taking hydroxyzine. Consult your healthcare provider for more information about hydroxyzine and drug interactions.
9 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Prescribers' Digital Reference.Vistaril.National Cancer Institute.CNS depressant.DailyMed.Hydroxyzine hydrochloride tablet.DailyMed.Hydroxyzine pamoate capsule.Schlit AF, Delaunois A, Colomar A, et al.Risk of QT prolongation and torsade de pointes associated with exposure to hydroxyzine: re-evaluation of an established drug.Pharmacol Res Perspect. 2017;5(3):e00309. doi:10.1002/prp2.309Mason JW.Antimicrobials and QT prolongation.J Antimicrob Chemother. 2017;72(5):1272–1274. doi:10.1093/jac/dkw591National Heart, Lung, and Blood Institute.Long QT syndrome.MedlinePlus.Ventricular tachycardia.López-Álvarez J, Sevilla-Llewellyn-Jones J, Agüera-Ortiz L.Anticholinergic drugs in geriatric psychopharmacology.Front Neurosci. 2019;13:1309. doi:10.3389/fnins.2019.01309
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Prescribers' Digital Reference.Vistaril.National Cancer Institute.CNS depressant.DailyMed.Hydroxyzine hydrochloride tablet.DailyMed.Hydroxyzine pamoate capsule.Schlit AF, Delaunois A, Colomar A, et al.Risk of QT prolongation and torsade de pointes associated with exposure to hydroxyzine: re-evaluation of an established drug.Pharmacol Res Perspect. 2017;5(3):e00309. doi:10.1002/prp2.309Mason JW.Antimicrobials and QT prolongation.J Antimicrob Chemother. 2017;72(5):1272–1274. doi:10.1093/jac/dkw591National Heart, Lung, and Blood Institute.Long QT syndrome.MedlinePlus.Ventricular tachycardia.López-Álvarez J, Sevilla-Llewellyn-Jones J, Agüera-Ortiz L.Anticholinergic drugs in geriatric psychopharmacology.Front Neurosci. 2019;13:1309. doi:10.3389/fnins.2019.01309
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Prescribers' Digital Reference.Vistaril.National Cancer Institute.CNS depressant.DailyMed.Hydroxyzine hydrochloride tablet.DailyMed.Hydroxyzine pamoate capsule.Schlit AF, Delaunois A, Colomar A, et al.Risk of QT prolongation and torsade de pointes associated with exposure to hydroxyzine: re-evaluation of an established drug.Pharmacol Res Perspect. 2017;5(3):e00309. doi:10.1002/prp2.309Mason JW.Antimicrobials and QT prolongation.J Antimicrob Chemother. 2017;72(5):1272–1274. doi:10.1093/jac/dkw591National Heart, Lung, and Blood Institute.Long QT syndrome.MedlinePlus.Ventricular tachycardia.López-Álvarez J, Sevilla-Llewellyn-Jones J, Agüera-Ortiz L.Anticholinergic drugs in geriatric psychopharmacology.Front Neurosci. 2019;13:1309. doi:10.3389/fnins.2019.01309
Prescribers' Digital Reference.Vistaril.
National Cancer Institute.CNS depressant.
DailyMed.Hydroxyzine hydrochloride tablet.
DailyMed.Hydroxyzine pamoate capsule.
Schlit AF, Delaunois A, Colomar A, et al.Risk of QT prolongation and torsade de pointes associated with exposure to hydroxyzine: re-evaluation of an established drug.Pharmacol Res Perspect. 2017;5(3):e00309. doi:10.1002/prp2.309
Mason JW.Antimicrobials and QT prolongation.J Antimicrob Chemother. 2017;72(5):1272–1274. doi:10.1093/jac/dkw591
National Heart, Lung, and Blood Institute.Long QT syndrome.
MedlinePlus.Ventricular tachycardia.
López-Álvarez J, Sevilla-Llewellyn-Jones J, Agüera-Ortiz L.Anticholinergic drugs in geriatric psychopharmacology.Front Neurosci. 2019;13:1309. doi:10.3389/fnins.2019.01309
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