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Hydroxyzine is an antihistamine medication used to treat anxiety, alleviate allergic reactions, improve insomnia, and act as a sedative before or after surgery. It causes a range of effects on the body, resulting in several potential side effects. Understanding hydroxyzine side effects can help people recognize concerning signs that require professional help.
- Hydroxyzine is used to treat anxiety, alleviate itchiness, and provide sedation.
- Hydroxyzine can cause various side effects, from mild to severe, which can require professional support and treatment.
- Hydroxyzine is not considered an addictive substance, although some psychological and physical dependence can occur, particularly in those with a history of substance use issues.
Common side effects of hydroxyzine
Hydroxyzine is available by prescription to treat anxiety symptoms, itchiness, and insomnia. [5] It is common to experience side effects of hydroxyzine when commencing treatment. These side effects tend to be mild and transient, typically resolving within days or weeks. [1]
Common side effects of hydroxyzine include: [1][2]
- Drowsiness
- Dizziness
- Dry mouth
- Fatigue
- Blurred vision
- Confusion
- Irritability
- Headache
- Urinary retention
Serious side effects
In some cases, side effects can occur that are rarer or more serious. In these cases, seeking professional support and treatment may be necessary. Rare or serious side effects of hydroxyzine include: [1][2][3]
- Convulsions
- Tremors
- Trouble breathing
- Allergic reaction, such as swelling or hives
- Hallucinations
- Changes in heart rate
- Extreme confusion
- Rash
- Priapism (erection lasting over four hours)
Serious side effects are more likely when using higher doses and in elderly patients. [2]
Special considerations for elderly patients and those with underlying conditions
Hydroxyzine may not be suitable for older adults. However, if it is deemed an appropriate medical treatment, this age group should be started on a low dose, which can be increased slowly as needed. Hydroxyzine can be unsafe for those over 65 years old due to the increased likelihood of underlying liver, kidney, or heart issues or other medical conditions in this age group. [2]
Additionally, the side effects of hydroxyzine can cause an increased risk of harm in elderly patients. For example, sedation and drowsiness may increase the risk of falls and confusion, potentially leading to accidents. [1]
Hydroxyzine may be unsafe for people with a history of heart problems, including arrhythmias, prolonged QT interval, heart attack, or heart disease. Because the medication can increase the risk of prolonged QT interval (part of the electrical conduction of the heart), people with heart conditions may be at higher risk of experiencing impaired cardiac function that could be fatal. [2][3]
Pregnancy
Hydroxyzine is not recommended for use during pregnancy or while breastfeeding. It is possible that the medication can cause birth defects when used in the first trimester, and it carries risks of side effects and seizures in infancy when used before or during labor. Similarly, during breastfeeding, hydroxyzine may pass to the infant via breast milk and may cause drowsiness and other side effects. [1][2]
It is important to discuss treatment options with a physician when planning to become pregnant, during pregnancy, or when breastfeeding, to ensure the safest and most appropriate treatment is provided and that symptoms are managed.
Psychological effects and addiction potential
Hydroxyzine is not considered an addictive substance, and, as such, it is not a controlled substance. It does not cause euphoric effects, which is a common trait of drugs of abuse. People using hydroxyzine as prescribed are unlikely to experience physical dependence and are therefore at low risk of experiencing withdrawal symptoms when treatment is stopped.
However, prolonged and excessive use of hydroxyzine could lead to some psychological or physical dependence and withdrawal symptoms, particularly if it is used alongside other substances. People might misuse hydroxyzine to enhance the sedating effects of other drugs, due to its anxiolytic and sedating effects. [4]
If any of the following signs emerge when using hydroxyzine, it may be necessary to seek professional help to manage hydroxyzine misuse or substance addiction:
- Spending increasing amounts of time thinking about or using hydroxyzine
- Using increasing amounts of hydroxyzine
- Neglecting responsibilities to use hydroxyzine
- Impairments in social, professional, or personal functioning due to hydroxyzine use
Practical tips for managing side effects
People can reduce the risk or severity of side effects by these steps: [1][3]
- Using hydroxyzine exactly as prescribed, taking the correct dosage at the correct time
- Not combining hydroxyzine with other substances, unless approved by a physician
- Consulting with the prescribing physician if concerning side effects emerge or do not go away
- Hydrating regularly, as this can help with fatigue and energy levels
- Maintaining a healthy lifestyle, exercise, and diet habits
- Taking measures to reduce the risk of harm caused by drowsiness and dizziness, such as not driving while using the medication and getting up slowly from a lying or seated position
Drug interactions and precautions
Hydroxyzine can interact with various medications. Some medications cause increased CNS depressant effects when used in combination with hydroxyzine, such as opioids, alcohol, and benzodiazepines. If concurrent use is medically necessary, reduced doses may be required. [2]
Certain medications and substances can cause an increased risk of prolonged QT length, causing dangerous heart arrhythmias. This can include some antibiotics, antidepressants, antipsychotics, antifungals, and heart medications. [1]
Always discuss with the prescribing doctor any medications, substances, or supplements currently or recently used before starting hydroxyzine treatment.
When to contact your healthcare provider
People using hydroxyzine should contact their healthcare provider if they notice serious or persistent side effects. It might be necessary to change the dosage or type of medication. Alternative medications are available. For example, hydroxyzine is a sedative antihistamine; people who experience issues relating to drowsiness caused by the medication might wish to change to a less drowsy antihistamine.
Additionally, people who are using hydroxyzine in an unintended manner, such as without a prescription, in higher or more frequent doses than prescribed, or with unintended administration methods, may require professional support and treatment to reduce and stop substance misuse.
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