What is hydroxyzine used for?

• Relieving allergic symptoms such as itchy skin (pruritus) due to allergic conditions like hives (chronic urticaria) and contact dermatitis (atopic and contact dermatoses)
• Treatment of itchy skin due to histamine (histamine-mediated pruritus)
• Treatment of generalized anxiety disorder and tension caused by mental distress since hydroxyzine reduces the activity in the central nervous system
• The use of hydroxyzine for anxiety for more than 4 months is not recommended.
• Used as a sedative agent with other medications before and after general anesthesia

There are other uses of hydroxyzine —your pharmacist or physician can give you further information.

How does hydroxyzine work?

When you come in contact with allergens (substances that your body may be allergic to), a natural body chemical called histamine is released. Histamine is responsible for allergic symptoms such as sneezing, itching, watery eyes, or runny nose.

Antihistamine is hydroxyzine’s drug class, meaning it blocks the effects of histamine. As a result, hydroxyzine relieves allergic symptoms and can cause drowsiness. 

However, unlike other antihistamines, hydroxyzine also affects the serotonin level in the central nervous system. Serotonin is responsible for mood-stabilizing and producing healthy sleeping patterns. That’s why hydroxyzine is the only antihistamine used for anxiety, especially when insomnia is involved. 

Hydroxyzine is metabolized (broken down) in the liver; its main and active metabolite is cetirizine, a second-generation antihistamine. Hydroxyzine is rapidly absorbed after being administered orally; it reaches its maximum plasma concentration at approximately 2 hours. 

What is the suggested dosing for hydroxyzine?

Typical adult dosage:
Anxiety: 

• Take 50 mg to 100 mg by mouth 4 times daily
• Treatment should be reassessed periodically; no data supporting the use of hydroxyzine for anxiety for longer than 4 months.

Hives and contact dermatitis:

• Take 25 mg by mouth 3 to 4 times daily

Sedation:

• Take 50 mg to 100 mg by mouth once

Typical pediatric dosage:
Anxiety, pruritus (itchy skin), atopic dermatitis (eczema), urticaria (hives):

• Under 6 years: Take 50 mg by mouth daily, given in divided doses
• Over 6 years: Take 50 to 100 mg by mouth daily, given in divided doses

Sedation - dosage is weight-based:

• By mouth: 0.6 mg/kg by mouth once
• Intramuscular administration for hydroxyzine hydrochloride injection: 1.1 mg/kg into a muscle once