Vistaril (Hydroxyzine Pamoate) – Oral

What Is Vistaril?

Vistaril (hydroxyzine pamoate) is an orally administered prescription medication used in adults and children to relieve itching caused by allergic skin reactions.

By itself or combined with other drugs, Vistaril also treats anxiety and tension in children and adults, and it's given as a sedative before and after general anesthesia for surgery.

Vistaril's primary ingredient, hydroxyzine pamoate, is an antihistamine that relaxes the skeletal muscles and blood vessels, and also has antiemetic (anti-nausea) and sedative effects.

Antihistamines are drugs that block the action of the compound histamine, which can cause itching, a runny nose, and watery eyes. Antihistamines also can prevent fevers in people receiving blood transfusions and treat allergies, coughs, and colds.

Histamines cause many allergy symptoms, including a runny nose or sneezing.

Vistaril is only available in oral capsule form. The liquid solution and intramuscular injection forms of administration have been discontinued. It is also available orally as a generic product, hydroxyzine pamoate.

What Is Vistaril Used For?

Vistaril is Food and Drug Administration (FDA)–approved for use under the following conditions in children and adults:

• Relief of anxiety and tension
• Itching from allergic reactions
• Sedation when used before and after general anesthesia

How to Take Vistaril

Take Vistaril as prescribed by your healthcare provider. Do not take more than directed. Vistaril may cause drowsiness, so it is important to avoid activities in which you’ll need to be mentally alert or coordinated until you know how Vistaril will affect you.

Vistaril usually is taken three or four times a day. Avoid drinking alcohol and avoid taking any other central nervous system (CNS) depressants while using Vistaril.

Storage

Store Vistaril in a closed container at room temperature, away from heat, moisture, and direct light. Do not store in a bathroom. Keep out of reach from children and pets.

Off-Label Uses

Vistaril may be prescribed off-label for certain, unapproved uses.

Off-label uses of Vistaril include:

• Treatment of chronic symptoms of interstitial cystitis (a chronic condition marked by inflammation in the tissues of the bladder wall)
• Relief of symptoms from seasonal allergic rhinitis (nasal inflammation caused by allergies)
  

What Are the Side Effects of Vistaril?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Vistaril include:

• Dry mouth
• Drowsiness
• Headache
• Abdominal pain
• Dizziness
• Pruritus

Severe Side Effects

Call your healthcare team immediately if you experience serious side effects while taking Vistaril. Call 911 if you feel the symptoms are life-threatening or if you’re experiencing a medical emergency.

Serious side effects and symptoms can include the following:

• Changes in heart rate such as a prolonged QT interval (the section on the electrocardiogram [ECG] that shows how long it takes for the electrical system to send an impulse through the heart's chambers) or torsades de pointes (a type of very fast heart rhythm, or tachycardia)
• Acute generalized exanthematous pustulosis (AGEP; a severe skin reaction)
• Seizures
• Thrombosis (blood clot in a vein, commonly the leg)
  

Dosage: How Much Vistaril Should I Take?

Modifications

Users should be aware of the following before beginning Vistaril:

Severe allergic reaction: Do not take Vistaril if you are allergic to its primary ingredient, hydroxyzine pamoate, or any other active or inactive ingredients.

Pregnancy: Discuss with your healthcare provider if you plan to become pregnant or are pregnant. They will help you weigh the benefits and risks of Vistaril during your pregnancy. Vistaril is highly discouraged in early pregnancy.

Breastfeeding: It is not known whether this drug is excreted in human milk. Therefore, it is not recommended to breastfeed while taking Vistaril.

Adults over 65: There is not enough information about Vistaril in older adults to see whether they respond differently than younger adults. Older adults with other medical conditions or who are taking multiple medications should use caution when taking Vistaril. Older adults may be more sensitive to side effects from medications.

Missed Dose

If you miss your dose of Vistaril, take a dose as soon as you remember. If it’s almost time for your next dose, wait until then and take your regular dose. Do not take extra medicine to make up for a missed dose.

Overdose: What Happens If I Take Too Much Vistaril?

Overdoses of Vistaril are rare but severe symptoms of toxicity include:

• Agitated delirium
• Psychosis (loss of contact with reality)
• Seizures
• Coma
• Hypotension (low blood pressure)
• QRS widening (when the bottom of the heart contracts later than normal)
• Ventricular dysrhythmias (irregular heartbeat, such as torsade de pointes)

If you suspect an overdose of Vistaril, seek medical attention immediately.

Precautions

What Are Reasons I Shouldn't Take Vistaril?

Consult with a healthcare provider if any of the following applies before beginning Vistaril:

• You have a known allergic reaction to hydroxyzine products or any of the other ingredients in Vistaril.
• You have a known allergic reaction to cetirizine hydrochloride or levocetirizine.
• You have a prolonged QT interval.

What Other Medications May Interact With Vistaril?

Other medications may affect how Vistaril works or how much of the drug is absorbed in the body. Vistaril also may alter the way other medications work when taken together.

Medications that may interact with Vistaril include:

• Antibiotics, such as azithromycin, Biaxin XL (clarithromycin), erythromycin, Zymaxid (gatifloxacin ophthalmic solution), and Avalox (moxifloxacin)
• Medications that treat depression, such as Celexa (citalopram) and Prozac (fluoxetine)
• Medications that treat heart rhythm problems, such as Pacerone (amiodarone), Pronestyl (procainamide), Qualaquin (quinine), and Betapace or Sorine (sotalol)
• Medications that treat mental health problems, such as chlorpromazine, Clozaril (clozapine), Fanapt (iloperidone), Seroquel (quetiapine), and Geodon (ziprasidone)

What Medications Are Similar?

Other medications used to treat symptoms of anxiety, itching, or hives or that are used as pre-surgical sedation, include:

• Xanax (alprazolam): Antianxiety medication
• Prozac (fluoxetine): Antianxiety/antidepressant medication
• Benadryl (diphenhydramine): Antihistamine used for allergy relief
• Bentyl (dicyclomine): Anticholinergic used to treat irritable bowel syndrome (IBD)

Please note that not all of these medications can be used in place of another.

How Can I Stay Healthy While Taking Vistaril?

Take Vistaril only as prescribed by your healthcare provider. If you do not see a reduction in anxiety symptoms while taking this medication, talk to your healthcare provider. 

Clinical studies have shown the value of Vistaril in treating anxiety for up to four months. Follow up with your healthcare provider regarding next steps if you're still experiencing anxiety and to find other ways to treat the condition, if necessary.