Vistaril Patient Tips

Medically reviewed by Carmen Pope, BPharm. Last updated on Nov 20, 2023.

1. How it works

• Vistaril is a brand (trade) name for hydroxyzine. Experts are not sure exactly how hydroxyzine works in the brain but suggest it may suppress activity in certain key regions of the subcortical area of the central nervous system (which is the part of the brain located below the cerebral cortex). Hydroxyzine has also demonstrated bronchodilator activity (opening up of the airways); antihistaminic (relieves symptoms of allergy including itch), antiemetic (relieves nausea and vomiting), and analgesic (pain-relieving) effects; as well as skeletal muscle relaxation.
• Vistaril belongs to the class of drugs known as diphenylmethanes. It may also be called an antihistamine.
• Some formulations of Vistaril have been discontinued in the United States, but Vistaril capsules (25mg and 50mg) and generic hydroxyzine are still available.

2. Upsides

• Effective at relieving itching due to allergies, chronic urticaria, histamine-mediated itch, or dermatitis (eczema).
• Has a calming effect and can cause drowsiness which means it may be used as a premedication before or after surgery.
• Calming properties may be useful in some people with anxiety who have not responded to other treatments.
• Available as oral capsules.
• Vistaril is available as a generic under the name hydroxyzine.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

• Drowsiness that may impair reaction skills, and affect a person's ability to drive or operate machinery. Alcohol should be avoided.
• May cause a dry mouth, mild skin eruptions or a rash, headache, or hallucinations. Side effects are generally mild and transient.
• Although it is sometimes used to manage itching, Vistaril may cause itching in some people.
• When used to manage itching or anxiety, Vistaril is usually taken four times a day.
• May interact with some other medications such as barbiturates, meperidine, narcotics, and other central nervous system depressants.
• The use of Vistaril as an antianxiety agent for more than four months has not been assessed in clinical studies.
• Vistaril is not suitable for some people including those who are allergic to cetirizine or levocetirizine, with a heart condition that causes a prolonged Q-T interval on ECG, or during early pregnancy.
• It is not clear if elderly people are more sensitive to the effects of Vistaril. As a precaution, lower dosages should be used, at least on initiation.
• May interact with some other medications such as barbiturates, meperidine, narcotics, and other central nervous system depressants.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Vistaril (hydroxyzine) may be used to relieve anxiety or itching. Drowsiness may occur, especially on dosage initiation, which may affect a person's ability to drive or operate machinery. Some formulations of Vistaril have been discontinued in the United States, but Vistaril capsules (25mg and 50mg) and generic hydroxyzine are still available.

5. Tips

• May be taken with or without food.
• Avoid alcohol.
• Do not drive, operate machinery, or perform tasks requiring alertness if this medicine makes you drowsy.
• Vistaril is available as capsules and an oral suspension. If using the oral suspension, shake it vigorously before use to ensure proper resuspension of the active ingredient.
• Seek urgent medical advice if you develop any signs of an allergic reaction (such as hives; difficulty breathing; swelling of your face, lips, tongue, or throat) or a severe skin reaction; if your heart starts to beat fast; if you develop a headache accompanied by chest pain, severe dizziness, or seizures.

6. Response and effectiveness

• Vistaril is rapidly absorbed from the gastrointestinal tract and its clinical effects are usually apparent within 15 to 30 minutes of oral administration.

7. Interactions

Medicines that interact with Vistaril may either decrease its effect, affect how long it works, increase side effects, or have less of an effect when taken with Vistaril. An interaction between two medications does not always mean that you must stop taking one of the medications; however, sometimes it does.

Speak to your doctor about how drug interactions should be managed. Common medications that may interact with Vistaril include:

• Alzheimer's disease medications, such as donepezil or galantamine
• anticholinergics, such as benztropine, or scopolamine
• antipsychotics, such as chlorpromazine, clozapine, fluphenazine, thioridazine, risperidone, or trazodone
• medications that can induce drowsiness, such as sleeping pills, first-generation antihistamines, muscle relaxants, most antidepressants, and anti-anxiety medications
• nervous system depressants, such as barbiturates
• pain relievers, such as acetaminophen, aspirin, ibuprofen, codeine, hydrocodone, or oxycodone.

Avoid drinking alcohol because it may increase the side effects of Vistaril.

Note that this list is not all-inclusive and includes only common medications that may interact with Vistaril. You should refer to the prescribing information for Vistaril for a complete list of interactions.

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Frequently asked questions

• Can you take hydroxyzine for anxiety and sleep?
• Can hydroxyzine be taken long-term?
• Does Benadryl help with or cause anxiety?
• When can I start drinking if I’m no longer taking hydroxyzine?
• Can dogs take hydroxyzine?
• Can you take antihistamines when pregnant?

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Vistaril only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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