What to Know About Atarax (Hydroxyzine)

Atarax is an antihistamine, but has many other uses

Atarax is technically an antihistamine, but it has many uses beyond allergies. It can be used to help treat anxiety and nausea, as well. It works on H1 receptor sites in the gastrointestinal and respiratory tract, as well as on blood vessels. It can help relax skeletal muscles, work as a bronchodilator, antihistamine, analgesic (pain relieving), and anti-emetic medication.

Atarax is available in the following forms:

  • Capsule
  • Tablet
  • Syrup
  • Intramuscular injection

Other brand names in the U.S. include Vistaril. Generic forms of this medication are also available.

Atarax can be used for anxiety, nausea, itching, and sedation
Jose Luis Pelaez Inc / DigitalVision / Getty Images

Uses

Atarax is indicated for these uses:

  • Anxiety
  • Pre-operative sedative
  • Itching and other skin conditions
  • Control of nausea and vomiting
  • Post-operative comfort
  • Pre- and post-partum relief of anxiety or vomiting

Before Taking

You may not be the best candidate for this medication if you have any of the following conditions. Be sure to review your medical history with your doctor before starting Atarax.

  • Electrolyte imbalances
  • Previous heart attack
  • Heart disease or heart failure
  • Abnormal heart rhythms
  • Some skin conditions
  • Glaucoma
  • Prostate problems
  • Some respiratory diseases

Talk to your doctor about all medications, supplements, and vitamins that you currently take. While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.

Precautions and Contraindications

You should not take Atarax if you:

  • Have sensitivity to hydroxyzine or its components
  • Are early in your pregnancy or are breastfeeding
  • You have a prolonged QT interval.

If you are over age 65, your doctor should consider whether other medications might be better suited for your condition. As this is a sedating medication, it can cause confusion and oversedation in people who are older, especially if they have reduced kidney function.

Other Antihistamines and Anti-Anxiety Medications

Other first-generation antihistamines include Benadryl (diphenhydramine) and Chlor-Trimeton (chlorpheniramine), while second generation antihistamines include Claritin (loratadine), Allegra (fexofenadine), and Zyrtec (cetirizine). Zyrtec is actually a less-sedating metabolite (breakdown product) of Atarax.

Other anti-anxiety medications include Xanax (alprazolam), Ativan (lorazepam), and Buspar (buspirone).

Dosage

Adult dosing of Atarax depends on the use.

  • Nausea and peripartum: 25 to 100 milligrams (mg) per dose
  • Anxiety and perioperative: 50 to 100 mg up to four times daily
  • Allergies: 25 mg three to four times daily

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.

Modifications

Medications doses may be reduced or used with care in elderly populations due to increased risks of confusion and other symptoms. There are no dosage adjustments for kidney or liver disease.

In children, there are alternatives to Atarax, but if it is used, doses range from 0.5 mg/kg/dose to 50 mg per dose. Check with your doctor before using Atarax in children.

How to Take and Store

Keep Atarax out of reach of children, and stored away from heat or light. If you miss a dose, take it as soon as possible. If it is too close to the next dose, skip the missed dose. Do not double dose this medication.

Side Effects

Common

These are typical side effects you may experience on Atarax. They are not emergencies:

  • Drowsiness
  • Dry mouth

Severe

Call your doctor immediately if you experience any of the following reactions:

  • Racing heart
  • Dizziness
  • Throat closing or trouble swallowing
  • Skin rash
  • Swelling of the tongue or mouth
  • Hives

Warnings and Interactions

Your doctor may choose to recommend against taking Atarax is you are also taking any of the following medications:

  • Bepridil
  • Calcium oxybate
  • Cisapride
  • Dronedarone
  • Magnesium oxybate
  • Mesoridazine
  • Pimozide
  • Piperaquine
  • Potassium oxybate
  • Saquinavir
  • Sodium oxybate
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Tranylcypromine
  • Ziprasidone

The following medications may have interactions with Atarax, and you should let your doctor know if you are taking any of these medications. You may need your doses adjusted or careful monitoring.

  • Alfentanil
  • Alfuzosin
  • Amiodarone
  • Amisulpride
  • Amitriptyline
  • Anagrelide
  • Apomorphine
  • Aripiprazole
  • Aripiprazole lauroxil
  • Arsenic trioxide
  • Asenapine
  • Astemizole
  • Atazanavir
  • Azithromycin
  • Bedaquiline
  • Benzhydrocodone
  • Bromazepam
  • Bromopride
  • Buprenorphine
  • Bupropion
  • Buserelin
  • Butorphanol
  • Cannabidiol
  • Carbinoxamine
  • Ceritinib
  • Cetirizine
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clofazimine
  • Clomipramine
  • Clozapine
  • Codeine
  • Crizotinib
  • Cyclobenzaprine
  • Dabrafenib
  • Dasatinib
  • Degarelix
  • Delamanid
  • Desipramine
  • Deslorelin
  • Deutetrabenazine
  • Dihydrocodeine
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Doxepin
  • Doxylamine
  • Droperidol
  • Ebastine
  • Efavirenz
  • Encorafenib
  • Entrectinib
  • Eribulin
  • Erythromycin
  • Escitalopram
  • Esketamine
  • Famotidine
  • Felbamate
  • Fentanyl
  • Fingolimod
  • Flecainide
  • Flibanserin
  • Fluconazole
  • Fluoxetine
  • Formoterol
  • Foscarnet
  • Fosphenytoin
  • Fostemsavir
  • Gabapentin
  • Gabapentin enacarbil
  • Galantamine
  • Gatifloxacin
  • Gemifloxacin
  • Glasdegib
  • Glycopyrrolate
  • Glycopyrronium tosylate
  • Gonadorelin
  • Goserelin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Histrelin
  • Hydrocodone
  • Hydromorphone
  • Hydroquinidine
  • Hydroxychloroquine
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Inotuzumab ozogamicin
  • Itraconazole
  • Ivabradine
  • Ivosidenib
  • Ketoconazole
  • Lapatinib
  • Lefamulin
  • Lemborexant
  • Lenvatinib
  • Leuprolide
  • Levofloxacin
  • Levorphanol
  • Lofexidine
  • Loxapine
  • Lumefantrine
  • Macimorelin
  • Meclizine
  • Mefloquine
  • Meperidine
  • Methacholine
  • Methadone
  • Metoclopramide
  • Metronidazole
  • Midazolam
  • Mifepristone
  • Mizolastine
  • Moricizine
  • Morphine
  • Morphine sulfate liposome
  • Moxifloxacin
  • Nafarelin
  • Nalbuphine
  • Nelfinavir
  • Nilotinib
  • Norfloxacin
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Ondansetron
  • Osilodrostat
  • Osimertinib
  • Oxaliplatin
  • Oxycodone
  • Oxymorphone
  • Ozanimod
  • Paliperidone
  • Panobinostat
  • Papaverine
  • Paroxetine
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Pentazocine
  • Periciazine
  • Perphenazine
  • Pimavanserin
  • Pipamperone
  • Pitolisant
  • Posaconazole
  • Pregabalin
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Remifentanil
  • Remimazolam
  • Revefenacin
  • Ribociclib
  • Risperidone
  • Ritonavir
  • Scopolamine
  • Secretin Human
  • Selpercatinib
  • Sertindole
  • Sertraline
  • Sevoflurane
  • Siponimod
  • Sodium phosphate
  • Sodium phosphate, dibasic
  • Sodium phosphate, monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sufentanil
  • Sulpiride
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Tapentadol
  • Telaprevir
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Tiotropium
  • Tizanidine
  • Tolterodine
  • Toremifene
  • Tramadol
  • Trazodone
  • Triclabendazole
  • Trimipramine
  • Triptorelin
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Vilanterol
  • Vinflunine
  • Voriconazole
  • Vorinostat
  • Zolpidem
  • Zuclopenthixol
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  1. U.S. National Library of Medicine DailyMed. Label: Hydroxyzine hydrochloride tablet. Updated November 28, 2017.

  2. UpToDate. Hydroxyzine.

  3. MedlinePlus. Hydroxyzine. Updated February 15, 2017.