Hydroxyzine; Uses, Dosage, Side Effects, Drug Interactions

Last updated: February 7, 2026Reviewed date: February 7, 2026Reading time: 5 min read

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Hydroxyzine is a piperazine derivative with antihistamine, antiemetic, and anxiolytic properties. Hydroxyzine's antihistaminic effect is due to its metabolite, cetirizine, a potent H1 receptor antagonist and selective inhibitor of peripheral H1 receptors. This agent competes with histamine for binding at H1-receptor sites on the effector cell surface. The sedative properties of hydroxyzine occur as...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Key Takeaways

This article explains Mechanism of Action of Hydroxyzine in simple medical language.
This article explains Indications of Hydroxyzine in simple medical language.
This article explains Contra-Indications of Hydroxyzine in simple medical language.
This article explains Side Effects of Hydroxyzine in simple medical language.

Educational health guideWritten for patient understanding and clinical awareness.

Reviewed content workflowUse writer and reviewer profiles for stronger trust.

Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
New weakness, severe pain, high fever, or symptoms after a serious injury.
Any symptom that feels urgent, unusual, or unsafe for the patient.

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

Before reading

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Start here Choose the right pathway for symptoms, reports, medicines, or urgent warning signs. Disease article roadmap Read this topic step by step: meaning, symptoms, warning signs, diagnosis, treatment, prevention, and follow-up. Treatment planner Prepare questions about treatment choices, benefits, risks, side effects, and follow-up. Family & caregiver guide Organize symptoms, reports, medicines, questions, and follow-up safely. Nutrition & diet guide Prepare food, hydration, supplement, and medicine-timing questions safely. Prevention guide Organize risk factors, protective habits, screening, and warning signs. Recovery guide Prepare a safe plan for activity, rehabilitation, warning signs, and follow-up.

Definition

Hydroxyzine is a piperazine derivative with antihistamine, antiemetic, and anxiolytic properties. Hydroxyzine’s antihistaminic effect is due to its metabolite, cetirizine, a potent H1 receptor antagonist and selective inhibitor of peripheral H1 receptors. This agent competes with histamine for binding at H1-receptor sites on the effector cell surface. The sedative properties of hydroxyzine occur as a result of the suppression of certain subcortical regions of the brain. Secondary to its central anticholinergic actions, hydroxyzine may be effective as an antiemetic.

Hydroxyzine is a first-generation antihistamine that is used largely for symptoms of itching, nausea, anxiety, and tension. Hydroxyzine has not been linked to instances of clinically apparent acute liver injury.

Mechanism of Action of Hydroxyzine

Hydroxyzine competes with histamine for binding at H₁-receptor sites on the effector cell surface, resulting in suppression of histaminic edema, flare, and pruritus. The sedative properties of hydroxyzine occur at the subcortical level of the CNS. Secondary to its central anticholinergic actions, hydroxyzine may be effective as an antiemetic.

The effects of the drug hydroxyzine on the activities of the rat liver monoamine oxidases and the membrane-bound and soluble forms of bovine semicarbazide-sensitive amine oxidase were studied. Hydroxyzine was found to be a competitive inhibitor of MAO-B (Ki – 38 microM), whereas it had a low potency towards MAO-A (IC50 > 630 microM). Although it was a relatively potent competitive inhibitor of bovine plasma SSAO (Ki approximately 1.5 microM), it was a weak inhibitor of the membrane-bound form of the enzyme from bovine lung (IC50 approximately 1 mM). These findings extend our knowledge of the drug binding capabilities of the amine oxidases and suggest that these interactions may contribute to the complex actions of this drug.

Indications of Hydroxyzine

Allergic Urticaria
Allergies
Anxiety
Interstitial Cystitis
Sedation
Nausea/Vomiting
Pruritus
Alcohol Withdrawal Syndrome
Pruritus
Psychomotor Agitation
Acute Anxiety
For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested. Useful in the management of pruritus due to allergic conditions such as chronic urticaria.

Contra-Indications of Hydroxyzine

Low amount of magnesium in the blood
Low amount of potassium in the blood
Wide-angle glaucoma
Closed-angle glaucoma
Heart attack
Prolonged QT interval on EKG
Chronic heart failure
Abnormal EKG with QT changes from birth
Stenosing peptic ulcer
Narrowing of opening between stomach and small intestine
Constipation
Blockage of urinary bladder
Enlarged prostate
Cannot empty bladder
Pregnancy

Side Effects of Hydroxyzine

The most common

Common

Less common

Chest pain or discomfort
cough
difficulty with swallowing
dizziness
fainting
fast heartbeat
hives, itching, or skin rash
irregular or slow heart rate
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
shortness of breath
tightness in the chest
unusual tiredness or weakness

Drug Interactions of Hydroxyzine

amiodarone
“azole” antifungals (e.g., itraconazole, ketoconazole, voriconazole)
barbiturates (e.g., butalbital, pentobarbital, phenobarbital)
carbamazepine
fluconazole
gemfibrozil
irbesartan
losartan
omeprazole
phenytoin
sulfonamide antibiotics (e.g., sulfadiazine, sulfamethoxazole, sulfisoxazole)
tocilizumab
tolbutamide
trimethoprim

Pregnancy & Lactation of Hydroxyzine

Pregnancy

Hydroxyzine should not be used during early pregnancy. It should be used during later pregnancy only if the potential benefits outweigh the risks.

Lactation

It is not known if hydroxyzine passes into breast milk. Hydroxyzine should not be used by breastfeeding mothers.

References

Hydroxyzine; Uses, Dosage, Side Effects, Drug Interactions

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

Write when the problem started and how it changed.
Bring old prescriptions, investigation reports, and current medicines.
Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

What is the most likely cause of my symptoms?
Which danger signs mean I should go to hospital quickly?
Which tests are necessary now, and which can wait?
How should I take medicines safely and what side effects should I watch for?
When should I come for follow-up?

Tests to discuss

Vital signs: temperature, pulse, blood pressure, oxygen saturation
Basic physical examination by a clinician
CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

Avoid heavy lifting, sudden bending, and prolonged bed rest.
Use comfortable posture and gentle movement as tolerated.
Discuss physiotherapy, X-ray, or MRI only when clinically needed.

OTC medicine safety

For mild back pain, pain-relief medicine may be discussed with a doctor or pharmacist.
Avoid repeated painkiller use if you have kidney disease, stomach ulcer, uncontrolled blood pressure, or are taking blood thinners.

Avoid these mistakes

Do not start antibiotics without a proper medical decision.
Do not use steroid tablets or injections casually for quick relief.
Do not delay emergency care because of home remedies.

Get urgent help if

Back pain with leg weakness, numbness around private area, loss of urine/stool control, fever, cancer history, or major injury needs urgent care.

Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Doctor / qualified healthcare provider

Tests to discuss with doctor

Basic vital signs: temperature, pulse, blood pressure, oxygen level if needed
Relevant blood, urine, imaging, or specialist tests only after clinical assessment

Questions to ask

What is the most likely cause of my symptoms?
Which warning signs mean I should go to emergency care?
Which tests are really needed now?
Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Go to emergency care if you notice:

Severe or rapidly worsening symptoms
Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration

Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.

Step 1
Check danger signs first

If danger signs are present, seek emergency care and do not wait for online information.
Step 2
Record the symptom story

Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.
Step 3
Visit a qualified clinician

A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.
Step 4
Do only useful tests

Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.
Step 5
Follow up and return early if worse

If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips

Take a written symptom diary and all previous prescriptions/test reports.
Do not hide medicines already taken, even herbal or over-the-counter medicines.
Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

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Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area from the RX Article Professional Blocks panel.

Hydroxyzine; Uses, Dosage, Side Effects, Drug Interactions

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