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Updated on September 13, 2023
6 min read

Why You Shouldn't Drink Alcohol While Taking Hydroxyzine

Ellie Swain
Written by 
8 Sources Cited
Ellie Swain
Written by 
8 Sources Cited

What is Hydroxyzine?

Most people understand drinking alcohol can adversely affect the body. However, only a few people know the potentially severe interactions that can occur when combining it with hydroxyzine.

This article discusses hydroxyzine and alcohol risks and provides helpful information about how they interact with one another.


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What is Hydroxyzine?

Hydroxyzine is a prescription-only antihistamine sold under the brand Vistaril. Antihistamines block the action of histamine, a substance in the body that leads to allergic symptoms. They also decrease activity in the brain.

Doctors use hydroxyzine to treat anxiety and allergies and use it as a sedating antihistamine.1 Hydroxyzine comes in the following forms:

  • Capsule
  • Tablet
  • Syrup
  • Oral suspension (consists of undissolved particles of one or more medicinal agents combined with liquid) 
  • Injection shot

Guidelines for Safe Hydroxyzine Usage

People usually take hydroxyzine three or four times a day. Strictly follow the directions, disclaimers, and drug information on your prescription label, and ask your doctor to explain any sections you don't understand.2

Moreover, take hydroxyzine precisely as directed. If taking it by suspension, shake it well before to ensure the medication mixes evenly.


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Precautions and Medical History Considerations Before Taking Hydroxyzine

Before taking hydroxyzine, tell your doctor if you're allergic to cetirizine, levocetirizine, or other substances.3 Hydroxyzine may contain inactive ingredients, leading to allergic reactions or other issues.

You should also speak to your doctor about your medical history, especially if you have any of the following health issues:3

  • Irregular heartbeat, known as prolonged QT interval
  • Breathing problems, such as emphysema or asthma
  • Pressure in the eye or glaucoma
  • High blood pressure
  • Kidney problems
  • Liver issues
  • Seizures
  • Stomach or intestine problems, such as ulcers or blockage
  • Overactive thyroid (hyperthyroidism)
  • Difficulty urinating, for example, due to enlarged prostate

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What Is Hydroxyzine Used For?

Adults and children take hydroxyzine to reduce itching from allergic skin reactions like hives.4 It can also combine with anesthesia for sedation, including tooth extractions.5

Doctors prescribe hydroxyzine to treat mental health issues, such as anxiety disorders and depression, because of its anxiolytic properties. Suppressing nervous and emotional conditions can help manage anxiety.

Hydroxyzine is particularly useful in treating generalized anxiety disorder (GAD) and may alleviate anxiety-related insomnia. 

Common Side Effects of Hydroxyzine

Taking hydroxyzine may lead to specific side effects. If any of the following symptoms are severe or persist, speak to your doctor for medical advice:3

  • Drowsiness
  • Dry mouth
  • Constipation, especially in older adults
  • Confusion, especially in older adults
  • Dizziness
  • Headache

Serious Side Effects of Hydroxyzine

Some side effects of hydroxyzine can be severe. If you experience any of the following side effects or symptoms, call your doctor or healthcare provider immediately:

  • Unintentional trembling or shaking movements
  • Seizures

Hydroxyzine and Skin Conditions

If you have any of the following symptoms of a severe skin condition, stop taking hydroxyzine, and speak to your doctor immediately:6

  • Rash
  • Skin peeling
  • Pus-filled, blister-like lesions
  • Areas of swelling and redness on the skin
  • Fever

Overdose Symptoms of Hydroxyzine

If someone has overdosed on hydroxyzine and displays severe symptoms such as passing out or having difficulty breathing, call 911. 

Symptoms of a hydroxyzine overdose may include:

  • Severe sleepiness
  • Seizures
  • Dizziness
  • Hypersedation
  • Convulsions
  • Stupor (near-unconsciousness) 
  • Nausea
  • Vomiting
  • In children, mental or mood changes, such as restlessness and irritability

Hydroxyzine for Alcohol Withdrawal 


Hydroxyzine was once one of the drugs used to treat alcohol withdrawal syndrome (AWS) until the late 1960s.7 Doctors didn’t know if the drug was better than others because there wasn’t enough research to compare the drugs.

However, in 1969, a study showed that the best drug to treat alcohol withdrawal syndrome was Librium or chlordiazepoxide. Librium worked much more effectively than hydroxyzine in people with AWS.

Librium is a benzodiazepine with a chemical structure vastly different from hydroxyzine. Today, benzodiazepines, including Librium, are now the drugs of choice for treating someone with AWS.


Doctors no longer recommend hydroxyzine to treat alcohol withdrawal syndrome (AWS). According to medical guidelines, it doesn't address the underlying cause of AWS — an imbalance of glutamate and gamma-aminobutyric acid (GABA) in the brain. 

Alcohol increases the effects of GABA and decreases glutamate. When you stop drinking, your glutamate levels surge, causing overexcitement in the brain, which can lead to withdrawal symptoms.

While drugs like benzodiazepines work by fitting into GABA receptors in the brain to calm it down, hydroxyzine doesn't affect either GABA or glutamate receptors. As a result, it can't counteract the excess glutamate that is causing the symptoms of AWS. For these reasons, hydroxyzine is no longer an effective treatment for those with AWS.

Can You Drink Alcohol While Taking Hydroxyzine?

You should avoid drinking alcohol while taking hydroxyzine, including beer and wine. Consuming alcohol with the drug can increase some of the side effects of the medicine, including:

Alcohol and Anxiety

Alcohol isn't the best idea if you're prone to anxiety. It interferes with neurotransmitters like serotonin, causing anxiety symptoms to worsen and persist even after the alcohol wears off. 

Unfortunately, those with social anxiety frequently turn to alcohol to navigate social settings, which only fosters dependence and exacerbates anxiety symptoms. Alcohol exacerbates anxiety symptoms instead of offering relief, although it may seem like a temporary solution.

Hydroxyzine and Alcohol Interaction & Risks

The drug interactions between hydroxyzine and alcohol can increase hydroxyzine's nervous system side effects. If you consume alcohol with hydroxyzine, it can be hard to determine if you're having severe consequences from the medication or not.

Seek emergency medical attention immediately if you experience these symptoms: 

  • Dizziness or drowsiness
  • Difficulty concentrating
  • Dry eyes
  • Dry mouth
  • Headache
  • Nausea
  • Seizures
  • Unintentional tremoring, trembling, or shaking
  • Fever
  • Rash or redness of the skin
  • Pus-filled or blister-like sores

Some people may also suffer from impairment in thinking and judgment. To reduce the risks of these drug interactions, don’t drink alcohol while taking hydroxyzine. Moreover, don’t use more than the recommended dose.

Hydroxyzine Interactions

You shouldn’t use hydroxyzine if you are:

  • Allergic to levocetirizine (Xyzal) or cetirizine (Zyrtec)
  • Pregnant
  • Suffering from an irregular heartbeat or long QT syndrome

Likewise, inform your doctor if you're taking other drugs that cause drowsiness, including:

  • Opioids (hydrocodone or codeine)
  • Anxiety and sleep medications (alprazolam, lorazepam, or zolpidem)
  • Muscle relaxers (cyclobenzaprine or carisoprodol)
  • Antihistamines (diphenhydramine, loratadine, or promethazine)

Other Hydroxyzine Interactions

Other drugs that are known to have serious adverse effects when interacting with hydroxyzine include, but aren’t limited to:8

  • Amiodarone
  • Citalopram
  • Clozapine
  • Droperidol
  • Eluxadoline
  • Fluoxetine
  • Iloperidone
  • Isocarboxazid
  • Procainamide
  • Quetiapine
  • Quinidine
  • Sodium Oxybate
  • Sotalol
  • Tranylcypromine
  • Ziprasidone

This isn’t a complete list of hydroxyzine drug interactions. Speak with your healthcare professional so they can provide medical advice when taking hydroxyzine.

How to Find Treatment for Alcohol Withdrawal Symptoms


Some people are worried about quitting drinking due to withdrawal symptoms. Still, alcohol detox is essential as the first step in treating alcohol use disorder (AUD).

Due to the severity of some withdrawal symptoms, a medical professional must supervise and monitor this process. This is especially important for people with lung or heart problems or other medical conditions, as their symptoms can rapidly worsen.

During detox, your treatment provider tracks your blood pressure and heart rate to ensure your health condition doesn’t decline. You can also speak with them about any symptoms you’re experiencing and if you’re in any pain. 

Medical Detox

When alcohol detox occurs in an inpatient rehab facility, physicians can use different medications to help reduce withdrawal symptoms. Medicines help keep a person's body chemicals balanced, reducing the risk of severe complications.

In some cases, medication can cause unwanted side effects or interfere with the detox process. In these circumstances, medical professionals use other remedies.

If you or a loved one needs professional help with alcoholism, contact an addiction specialist for more information about treatment.

Updated on September 13, 2023
8 sources cited
Updated on September 13, 2023
All Alcoholrehabhelp content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies.
  1. U.S. National Library of Medicine. “Hydroxyzine.” National Center for Biotechnology Information, 2017.
  2. VISTARIL® (hydroxyzine pamoate) Capsules and Oral Suspension.” Pfizer Labs, 2014.
  3. U.S. National Library of Medicine. “Cetirizine Injection.” MedlinePlus, 2022.
  4. Gober et al. “Hydroxyzine Use in Preschool Children and Its Effect on Neurodevelopment: A Population-Based Longitudinal Study.” Frontiers in Psychiatry, 2022. 
  5. Hydroxyzine.” The IUPHAR/BPS Guide to PHARMACOLOGY, (n.d.). 
  6. Entringer, S. “Hydroxyzine.”, 2022.
  7. Stern et al. “Current Approaches to the Recognition and Treatment of Alcohol Withdrawal and Delirium Tremens: “Old Wine in New Bottles” or “New Wine in Old Bottles.” Primary Care Companion to the Journal of Clinical Psychiatry, 2010.
  8. Cunha, J. “HYDROXYZINE.” RxList, 2021.
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