Hydroxyzine and Alcohol: All You Need to Know!

Written by

Jessica Guht

Jessica is a medical writer with an unquenched thirst to discover something new. She believes that medical content should be accessible to everyone and strives to write content that every single person can understand. When Jessica isn’t writing, she can usually be found reading a book with a dog cuddled in her lap. Jessica has a Masters of Engineering degree in Biomedical Engineering.

Medically reviewed by

Amy Dougherty, FNP-BC, AGAC

Amy is a Board Certified Family Health Nurse Practitioner (FNP) with over 15 years of experience working in Hospital Medicine, Urgent Care and Primary Care practices. Amy graduated Thomas Jefferson University with high distinction earning a Bachelor of Science in Nursing in 2008, a Master of Science in Nursing in 2010 and a Post Master's Certificate in Adult Gerontology Acute Care (AGAC) in 2014. She was recognized by the Elite American Nurses Association in 2013 for her dedication, achievements and leadership in the field Nursing. She served as a clinical preceptor for a number of Nurse Practitioner students and enjoys teaching the bright minds of future NPs.

Those with anxiety may find themselves turning to alcohol as a way to find relief from their symptoms through comfort and relaxation. However, it can be risky to continue this habit while taking medication for anxiety.

Hydroxyzine is a common antihistamine used to treat anxiety, but it can be dangerous when combined with alcohol. Alcohol use amplifies the side effects of hydroxyzine, and it can also increase the risk of adverse events such as sores, trembling, and seizures. Because of these risks, it is typically recommended to avoid drinking alcohol while taking hydroxyzine to protect your health.

Table of Contents

• What Is Hydroxyzine?
• Can You Drink Alcohol on Hydroxyzine?
• Hydroxyzine and Alcohol Interactions
• Hydroxyzine and Alcohol Risks
• How Long After Taking Hydroxyzine Can I Drink Alcohol?
• Other Interactions with Hydroxyzine
• When to See a Doctor?
• Key Takeaways

What Is Hydroxyzine?

Hydroxyzine is an antihistamine used to treat many different health conditions. Antihistamines work by blocking the actions of histamines, which is a substance that causes the symptoms of allergies and an allergy attack.

As an antihistamine, hydroxyzine’s most prominent use is to relieve itching due to allergic skin reactions.

However, hydroxyzine is also used to relieve anxiety and tension, and when used for this purpose, it may be used with other medications. It accomplishes this by reducing activity in the brain.

Hydroxyzine may also be used with other medications as a sedative before or after general anesthesia for surgery.

Can You Drink Alcohol on Hydroxyzine?

It is important to avoid drinking alcohol while taking hydroxyzine. When alcohol interacts with hydroxyzine, it can decrease the benefits of the medicine, making it not as effective and worsening your condition. Additionally, when alcohol combines with hydroxyzine, it may increase the medication’s adverse effects.

Hydroxyzine and Alcohol Interactions

The potential side effects of hydroxyzine are similar to those experienced by those who drink. 

Common side effects of hydroxyzine include:

• dry eyes
• sleepiness
• daytime drowsiness
• headache
• dry mouth
• nausea

When combining hydroxyzine with alcohol, the side effects increase in severity; something called an additive effect.

Hydroxyzine and Alcohol Risks

There are also some severe side effects of hydroxyzine that can be magnified with alcohol. These side effects include:

• unintentional trembling, tremoring, or shaking
• seizures
• rash or redness of the skin
• fever
• blister-like or pus-filled sores

When taking alcohol with hydroxyzine, the odds of experiencing one of these adverse effects can increase. Additionally, it can be harder to tell if the adverse effect is from the medication.

If you notice any of these side effects while taking hydroxyzine, seek immediate medical attention and discontinue hydroxyzine use.

It is essential to always follow the prescription instructions, as mixing alcohol and hydroxyzine can be a potentially serious or deadly interaction. Those at an increased risk of adverse effects include older adults, those with kidney or liver problems, and those taking other medications affecting the central nervous system.

How Long After Taking Hydroxyzine Can I Drink Alcohol?

The peak effects of hydroxyzine are felt within 2 hours, and the most noticeable anxiety effects are typically gone within 4 to 6 hours. However, hydroxyzine lasts for much longer in the body.

Hydroxyzine has a half-life of 12 hours, so it remains in the body long after you may notice the benefits. For those with kidney or liver problems, the half-life can be even longer.

Because experts calculate that it takes 4 to 5 half-lives for a drug to be completely cleared from the body, it is recommended to wait 48 to 60 hours, or 2 to 2.5 days, before drinking alcohol again. 

Other Interactions with Hydroxyzine

There are certain classes of medications that may increase the levels and effects of hydroxyzine, and they include:

• other antihistamines (e.g., cetirizine (Zyrtec), diphenhydramine (Benadryl))
• other medications causing drowsiness (e.g., zolpidem (Ambien))
• other medications with anticholinergic effects (e.g., benztropine (Cogentin))
• other medications increasing the heart’s QT interval (e.g., citalopram (Celexa), amitriptyline (Elavil), methadone)

People with the following qualities should also be wary of taking hydroxyzine:

Older Adults

Being over the age of 65 places you at a higher risk of stronger side effects of hydroxyzine. It is often recommended for older adults to use alternative medications, with many older adults finding them to be safer.

Prolonged QT Interval

Those who have a prolonged QT interval, or abnormal electrical activity of the heart, should avoid hydroxyzine as it can lead to severe complications. Additionally, anyone with a history of heart attack, heart disease, heart failure, or other heart problems should avoid hydroxyzine.

Illegal Drugs

Similar to alcohol, taking hydroxyzine with illegal drugs can increase the risk of serious adverse effects.

Low Blood Levels of Magnesium or Potassium

Individuals with low blood levels of magnesium or potassium may experience serious side effects when taking hydroxyzine. Additionally, alcohol can deplete important electrolytes, which can make this effect even worse.

When to See a Doctor?

When taking a new medication, it is always important to monitor for potential side effects and adverse reactions.

For those taking hydroxyzine for anxiety, it is crucial to see a doctor immediately if any of the following symptoms are present:

• rapid heart rate
• problems breathing
• severe drowsiness or inability to wake
• hallucinations
• facial swelling or hives

How Can DrHouse Help?

If you think that you may need a prescription for hydroxyzine, DrHouse can help. In just 15 minutes, you can meet with an online doctor to discuss your symptoms and determine if hydroxyzine is the right medication for you.

Key Takeaways

Hydroxyzine is an antihistamine with many purposes, such as for allergies, anxiety, or as a sedative.

There are some side effects and serious adverse events that are associated with hydroxyzine, and the risk of these severe events increases when combining alcohol with hydroxyzine. This is because alcohol and hydroxyzine have an additive effect, making their similar symptoms even worse.

Because of these interactions, it is recommended to avoid drinking alcohol while taking hydroxyzine. There are also other medications and health conditions that should be avoided or monitored in those who take hydroxyzine, and it is important to discuss all this with a doctor to determine if hydroxyzine is the best choice for you.

Sources:

• Mental Health Medications | NAMI: National Alliance on Mental Illness . (2022). Retrieved 24 July 2022, from https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Hydroxyzine-(Vistaril-Atarax) 
• Atarax: Hydroxyzine Hydrochloride. (2019). https://gskpro.com/content/dam/global/hcpportal/en_SG/products/PDF/atarax/pdf/atarax_pi_ncds06si_approved_17sep19.pdf 
• Hydroxyzine: MedlinePlus Drug Information. (2022). Retrieved 24 July 2022, from https://medlineplus.gov/druginfo/meds/a682866.html 
• Guaiana, G., Barbui, C., & Cipriani, A. (2010). Hydroxyzine for generalised anxiety disorder. Cochrane Database Of Systematic Reviews. doi: https://www.doi.org/10.1002/14651858.cd006815.pub2 
• Houze-Cerfon, C., Balen, F., Houze-Cerfon, V., Motuel, J., Battefort, F., & Bounes, V. (2021). Hydroxyzine for lowering patient’s anxiety during prehospital morphine analgesia: A prospective randomized double blind study. The American Journal Of Emergency Medicine, 50, 753-757. doi: https://www.doi.org/10.1016/j.ajem.2021.09.061 
• National Center for Biotechnology Information (2022). PubChem Compound Summary for CID 3658, Hydroxyzine. Retrieved July 24, 2022 from https://pubchem.ncbi.nlm.nih.gov/compound/Hydroxyzine .