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.

Drug Facts

Generic Name: Hydroxyzine pamoate

Brand Name(s): Vistaril

Drug Availability: Prescription

Administration Route: Oral

Therapeutic Classification: Respiratory agent

Available Generically: Yes

Controlled Substance: N/A

Active Ingredient: Hydroxyzine pamoate

Dosage Form(s): Capsule

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)

How Long Does Vistaril Take to Work

Because Vistaril is rapidly absorbed in the gastrointestinal (GI) tract, symptom improvement is usually noted within 15 to 30 minutes after taking the drug.

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:

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)

Report Side Effects

Vistaril may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Vistaril Should I Take?

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The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (capsules or suspension):
    • To help control anxiety and tension:
      • Adults—50 to 100 milligrams (mg) 4 times a day.
      • Children 6 years of age and older—50 to 100 mg per day, divided in small doses.
      • Children younger than 6 years of age—50 mg per day, divided in small doses.
    • To relieve the symptoms of an allergic reaction:
      • Adults—50 to 100 milligrams (mg) 4 times a day.
      • Children 6 years of age and older—50 to 100 mg per day, divided in small doses.
      • Children younger than 6 years of age—50 mg per day, divided in small doses.
    • For controlling anxiety and produce sleep before surgery:
      • Adults—50 to 100 milligrams (mg) a day.
      • Children—Dose is based on body weight and must be determined by your doctor. The dose is usually 0.6 milligram (mg) per kilogram (kg) of body weight per day.

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.

What Happens If I Overdose on Vistaril?

If you think you or someone else may have overdosed on Vistaril, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Vistaril, call 911 immediately.

Precautions

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It is very important that your doctor check your progress at regular visits. This will allow your doctor to see if the medicine is working properly and to decide if you should continue to use it.

Call your doctor if your symptoms do not improve or if they get worse.

Make sure your doctor knows if you are pregnant. Do not use this medicine during the early part of a pregnancy unless your doctor tells you to.

This medicine may make you dizzy or drowsy. Do not drive or do anything that could be dangerous until you know how this medicine affects you.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that make you drowsy or less alert). Some examples of CNS depressants are antihistamines or medicine for allergies or colds, sedatives, tranquilizers or sleeping medicine, prescription pain medicine or narcotics, medicine for seizures or barbiturates, muscle relaxants, or anesthetics, including some dental anesthetics. Check with your doctor before taking any of the above while you are using this medicine.

Contact your doctor right away if you have any changes to your heart rhythm. You might feel dizzy or faint, or you might have a fast, pounding, or uneven heartbeat. Make sure your doctor knows if you or anyone in your family has ever had a heart rhythm problem such as QT prolongation.

This medicine may cause a serious skin condition called acute generalized exanthematous pustulosis (AGEP). Tell your doctor if you have a fever, skin rash, or worsening of skin problems after using this medicine.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

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:

What Medications Are Similar?

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

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

Frequently Asked Questions

  • What is Vistaril used for?

    Vistaril is commonly used to treat the following conditions:

    • Relief of anxiety and tension
    • Itching from allergic reactions
    • Sedation when used before and after general anesthesia
  • What impact does Vistaril have on the body?

    Vistaril works within the body for:

    • Skeletal muscle relaxation
    • Relaxation of the muscles in the lungs and airways (bronchodilation)
    • Sedation
    • Anti-nausea 
    • Antihistamine
    • Blocking acetylcholine in the body (anticholinergic)
  • What are the common side effects of Vistaril?

    Common side effects associated with Vistaril include:

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

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.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Dailymed. Label: Vistaril (hydroxyzine pamoate) capsules and oral suspension.

  2. MedlinePlus. Antihistamines for allergies.

  3. Britannica. Histamine.

  4. MedlinePlus. Hydroxyzine.

  5. Prescribers' Digital Reference. Hydroxyzine pamoate - drug summary.

  6. National Alliance on Mental Illness. Hydroxyzine (Vistaril, Atarax).