Key takeaways

  • Mild side effects of hydroxyzine include sleepiness, dry mouth, and headache.
  • Serious side effects of hydroxyzine include heart-related issues and severe allergic reactions. Note that serious side effects from this drug are rare.
  • Hydroxyzine is not recommended during pregnancy or breastfeeding.

Hydroxyzine is a generic prescription drug prescribed for the following purposes in adults and some children:

  • to treat anxiety
  • to help induce sedation (a state of sleepiness and relaxation) before surgery
  • to treat itchy skin from an allergic condition such as eczema or hives

Hydroxyzine comes as a tablet or capsule that you swallow. The tablet form is called hydroxyzine hydrochloride. The capsule form is called hydroxyzine pamoate. Hydroxyzine also comes as a liquid solution you take by mouth and in certain injectable forms, but these are not covered in this article.

All forms contain the same active ingredient, hydroxyzine. (An active ingredient is what makes a drug work.) This article will refer to both the tablet and capsule form as “hydroxyzine.”

You may take hydroxyzine short term or long term, depending on the condition you’re taking it to treat.

This article describes hydroxyzine’s side effects.

Some people may experience mild to serious side effects during their hydroxyzine treatment. Not everyone will experience side effects. Examples of hydroxyzine’s commonly reported side effects include:

To learn more about dry mouth or headache, see the “Side effects explained” section.

If you experience side effects when you take hydroxyzine, they’ll likely be mild. Examples of mild side effects that have been reported with hydroxyzine include:

To learn more about some of these side effects, see the “Side effects explained” section.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have any symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking hydroxyzine unless your doctor recommends it.

Hydroxyzine may cause mild side effects other than the ones listed here. For details, see the prescribing information for hydroxyzine tablets and hydroxyzine capsules.

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In rare cases, people may have serious side effects from taking hydroxyzine. Serious side effects that have been reported with hydroxyzine include:

  • cardiac (heart-related) side effects
  • skin reactions, such as acute generalized exanthematous pustulosis or a serious rash
  • tremors
  • convulsions
  • uncontrolled movements
  • severe allergic reaction

To learn more about cardiac side effects or allergic reaction, see the “Side effects explained” section.

If you develop serious side effects while taking hydroxyzine, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone by giving doctors and researchers more information about how the drug works in real life. If you develop a side effect while taking hydroxyzine and want to tell the FDA about it, visit MedWatch or call 800-332-1088.

Get answers to some frequently asked questions about hydroxyzine’s side effects.

Does hydroxyzine cause sexual side effects in females or males?

No, hydroxyzine is not known to cause sexual side effects. This kind of side effect was not reported in studies of the drug.

If you’re concerned about sexual side effects during hydroxyzine treatment, talk with your doctor.

Note: The use of binary terms such as “male” and “female” or “men” and “women” in this article reflects the language of the sources we’ve used. Unless otherwise noted, it’s unclear whether the research we reference included participants with expansive gender identities.

Is weight gain a side effect of hydroxyzine?

No, hydroxyzine should not cause weight gain. This was not a side effect reported in studies of the drug.

If you’re concerned about changes in weight, talk with your doctor.

Can hydroxyzine’s side effects vary depending on whether it’s taken for inducing sedation or treating anxiety?

Your risk of certain side effects from hydroxyzine may vary based on factors such as your treatment length or the condition you’re taking the drug to treat. For instance, you may experience different side effects if you’re taking it once for sedation before surgery compared with taking it long term for anxiety or itchy skin.

On the other hand, the risk of certain common side effects is the same regardless of treatment length or condition being treated. An example is sleepiness.

Certain people also have a higher risk of side effects based on their health status. See the “Hydroxyzine warnings” section to learn about conditions that might make you more likely to have side effects from this drug.

Is my risk of side effects lower if I take the 25-mg dose of hydroxyzine compared with the 50-mg dose?

It depends. Hydroxyzine is taken in lower doses in certain groups, such as older adults (ages 65 years and older), young children, and people with kidney or liver problems. The lower dose helps reduce the risk of side effects.

Studies did not specifically report more side effects in these populations when they took higher doses of hydroxyzine that fall within the recommended dosage range. But some side effects, such as seizures or slowed breathing, can occur if a person takes very high doses of hydroxyzine.

Your risk of having side effects depends on several factors. If you think you’re more likely to experience a side effect because of a condition you already have, talk with your doctor. They may suggest starting your treatment with a lower dose, or they may recommend a different medication for you.

Do older people have a higher risk of side effects from hydroxyzine compared with younger people?

It’s possible. Older adults are more likely to have problems with kidney or liver function, which means that their bodies may take longer to break down the drug.

In some cases, adults ages 65 years and older may be prescribed a lower dose of hydroxyzine to reduce the risk of side effects. Older adults are more likely to have certain side effects from hydroxyzine, including sleepiness and confusion.

Your doctor will monitor your body’s response to the drug and determine whether your dosage should be adjusted to ease your side effects. If you experience bothersome side effects during your hydroxyzine treatment or you’re concerned about your risk of a certain side effect, talk with your doctor.

Learn more about some of the side effects hydroxyzine may cause.

Headache

Some people who take hydroxyzine may experience a headache. This was a common side effect reported in studies. In most cases, headaches from hydroxyzine are mild and usually go away on their own.

What might help

If you get a headache from taking hydroxyzine, here are a few tips to help manage it:

  • Drink plenty of water each day.
  • Apply a warm or cool compress to your forehead.
  • Take an over-the-counter (OTC) pain reliever such as acetaminophen or ibuprofen. (Talk with your doctor or pharmacist first to make sure it’s safe to take with hydroxyzine.)
  • Try a natural headache remedy after checking with your doctor that it’s safe.

If your headache is bothersome or does not go away, talk with your doctor about other options to treat it.

Cardiac side effects

Hydroxyzine may cause a cardiac side effect called long QT syndrome. With this condition, your heart takes longer than usual to contract and relax. This increases your risk of developing a life threatening condition called Torsade de Pointes.

If you feel fluttering or palpitations in your chest or you faint without a known cause, these could be signs of an atypical heart rhythm. (The term “palpitations” refers to a feeling of skipped or extra heartbeats.)

What might help

If you think you may be experiencing a heart-related side effect during your hydroxyzine treatment, talk with your doctor or seek medical care right away.

If you have a condition that causes an atypical heart rhythm or you take a medication that raises your risk of this side effect, your doctor may not prescribe hydroxyzine for you.

If you experience heart-related side effects during your treatment, your doctor may have you stop taking hydroxyzine and switch to a different medication.

Dry mouth

Some people may have dry mouth while taking hydroxyzine. In studies of the drug, dry mouth was a common side effect.

What might help

If you have dry mouth during your hydroxyzine treatment, you may be able to manage this side effect without medication. Some remedies to try at home include:

  • sipping water during the day
  • chewing sugar-free gum
  • using a humidifier in your home
  • avoiding caffeine

You can also talk with your doctor about whether an OTC saliva substitute in the form of a spray or lozenge might help.

Allergic reaction

Like most drugs, hydroxyzine can cause an allergic reaction in some people. This was a side effect in studies of the drug.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • a steroid you take by mouth
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to hydroxyzine, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to hydroxyzine, they may have you switch to a different treatment.

Keeping track of side effects

During your hydroxyzine treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how hydroxyzine affects you. They can then use this information to adjust your treatment plan if needed.

Hydroxyzine may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether hydroxyzine is a good treatment option for you.

Talk with your doctor about your health history before starting hydroxyzine treatment. Factors to consider include those listed here:

  • heart rhythm problems
  • liver or kidney problems
  • a condition that affects your metabolism, digestion, or urination, such as overactive thyroid or difficulty urinating
  • a condition that affects breathing, such as asthma
  • a condition that affects vision, such as glaucoma
  • a condition that affects muscle movements, such as myasthenia gravis or seizures
  • an allergic reaction to hydroxyzine or any of its ingredients
  • an allergic reaction to Zyrtec (cetirizine) or Xyzal (levocetirizine), which are similar to hydroxyzine

Alcohol and hydroxyzine

You should not drink alcohol during your hydroxyzine treatment. Both alcohol and hydroxyzine can cause sleepiness, confusion, or dizziness. As a result, combining alcohol with hydroxyzine can raise your risk of these side effects. In addition, it could worsen such side effects if you experience them.

If you’re concerned about avoiding alcohol during your hydroxyzine treatment, talk with your doctor.

Pregnancy and breastfeeding while taking hydroxyzine

You should not take hydroxyzine during pregnancy. In fact, hydroxyzine is contraindicated in pregnancy. (“Contraindicated” means doctors will not prescribe this drug to people who are pregnant due to the risk of harm.)

In addition, it is not recommended to take hydroxyzine while breastfeeding.

If you’re pregnant or breastfeeding, or planning to become pregnant or to breastfeed, talk with your doctor about your treatment options.

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.