Hydroxyzine and Alcohol: Understanding the Risks and Effects

Medical Providers:
Dr. Michael Vines, MD
Alex Spritzer, FNP, CARN-AP, PMHNP
Clinical Providers:
Natalie Foster, LPC-S, MS
Last Updated: September 23, 2024

Hydroxyzine and Alcohol

Hydroxyzine is a drug prescribed for anxiety, allergies, and various other issues. It functions by soothing the central nervous system (CNS), which makes it useful for short-term treatment. Still, using hydroxyzine together with alcohol may cause serious side effects. In this piece, we’ll look at what hydroxyzine treats, its possible side effects, and the dangers of pairing it with alcohol.

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What is Hydroxyzine Used For?

Hydroxyzine is an antihistamine with several medical uses. It is most commonly prescribed for anxiety because its sedative qualities help relax the central nervous system. It may also be used for a range of other concerns, such as:

  • Allergies and itching: It helps ease symptoms like itching and hives linked to allergic reactions.
  • Nausea and vomiting: In some cases, it’s given to reduce nausea and vomiting.
  • Sleep support: Because it can cause drowsiness, hydroxyzine is sometimes recommended for insomnia or trouble sleeping.

Hydroxyzine is generally intended for short-term use, though a healthcare provider can decide on the most appropriate long-term approach for anxiety care.

What to Do If You Miss a Dose of Hydroxyzine?

If you forget a dose of hydroxyzine, take it when you remember. If your next scheduled dose is near, skip the missed one and continue with your regular schedule.

Avoid taking two doses at once to make up for a missed dose, since this raises the chance of side effects. Be sure to follow your doctor’s directions closely.

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Hydroxyzine Side Effects

Although hydroxyzine is typically safe when taken as directed, it can still produce side effects. Some of the most frequently reported ones include:

  • Dry mouth
  • Sleepiness or sedation
  • Dizziness
  • Blurred vision
  • Headaches
  • Constipation

In rarer but more serious situations, hydroxyzine may affect the heart, including causing an irregular rhythm called QT prolongation. This issue can raise the risk of cardiac complications, particularly when combined with other drugs or substances such as alcohol.

Those using hydroxyzine should also watch for signs of an allergic reaction, such as trouble breathing, swelling of the face or throat, or hives. If any of these develop, seek medical care right away.

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Can You Take Hydroxyzine and Alcohol Together?

The brief answer is no—drinking alcohol while taking hydroxyzine is not recommended. Alcohol can amplify the medication’s sedative effects and lead to harmful outcomes. These can include:

  • Increased drowsiness: Using both together may result in extreme sleepiness, making it hard to stay alert or function as usual. This raises the chance of accidents.
  • Reduced coordination: Both alcohol and hydroxyzine impact coordination and reflexes. Mixing them can make driving, using equipment, or handling routine tasks unsafe.
  • Mental clouding: Combining hydroxyzine with alcohol can affect clear thinking, making judgments and decisions more difficult.
  • Breathing suppression: Together, they can slow breathing and create possible respiratory risks, particularly at higher amounts.
  • Cardiac risks: Hydroxyzine may lengthen the QT interval, and adding alcohol can further elevate the risk of heart-related issues, especially for those with existing heart concerns.

Hydroxyzine is commonly used for anxiety and sleep problems. Because alcohol is also a depressant, using both at the same time can intensify anxiety, stress, or depressive symptoms, potentially making matters worse.

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Hydroxyzine and Alcohol Withdrawal

Although mixing alcohol and hydroxyzine is risky, there are situations where hydroxyzine may be used during alcohol withdrawal with medical oversight. Even so, it is not a primary treatment for alcohol withdrawal syndrome (AWS).

Stopping alcohol use can be difficult, and withdrawal often brings symptoms like anxiety, restlessness, and trouble sleeping.

Hydroxyzine may ease some of these symptoms by:

  • Lowering anxiety: Its calming effects can help reduce feelings of anxiety during recovery.
  • Supporting sleep: Its sedating qualities may improve sleep, which can make withdrawal easier to handle.

However, hydroxyzine does not treat severe or life-threatening AWS symptoms such as seizures or delirium tremens (DTs). Its use in this setting should always be directed by a medical professional.

Risks of Using Hydroxyzine During Alcohol Withdrawal

Potential concerns with hydroxyzine use in withdrawal include:

  • Heart-related issues
  • Sleepiness and mental confusion
  • Risk of dependence or misuse
  • Other medical complications

Alcohol misuse and withdrawal carry significant risks, and hydroxyzine should only be used within a structured treatment plan. Do not self-medicate or combine hydroxyzine with alcohol during withdrawal.

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