Atarax is the brand name for hydroxyzine hydrochloride, a first-generation antihistamine with central sedative properties. It blocks histamine H1 receptors and has anticholinergic and antiemetic activity, which together help reduce itching, calm the nervous system, ease nausea, and promote sleep. In clinical practice, hydroxyzine is used for short-term management of anxiety and tension, relief of pruritus (itching) due to allergic conditions such as eczema, dermatitis, and urticaria (hives), and as premedication to enhance sedation before and after surgery. Many clinicians also use it as a non-habit-forming option to help patients with transient insomnia or nighttime anxiety.
How it works: By antagonizing H1 receptors in the brain and periphery, Atarax reduces histamine-driven symptoms like itching and hives. Its anticholinergic effects contribute to sedation and anti-nausea benefits but also account for side effects such as dry mouth or constipation. Hydroxyzine is metabolized to cetirizine (a second-generation antihistamine), which may contribute to its longer-lasting anti-itch effects. Compared with non-sedating antihistamines, Atarax crosses the blood–brain barrier and therefore has stronger calming and sleep-promoting effects.
Clinical roles at a glance:
Important distinctions: Atarax (hydroxyzine hydrochloride) and Vistaril (hydroxyzine pamoate) contain the same active drug but different salts; both offer antihistamine and anxiolytic effects. Choice of salt form is typically based on prescriber preference and availability rather than major clinical differences.
Always follow your prescriber’s instructions. Dose ranges vary by indication, age, and individual response. Start with the lowest effective dose to minimize side effects, especially sedation.
Typical adult dosing:
Elderly and frail adults:
Pediatric dosing (if prescribed by a clinician):
Renal or hepatic impairment:
Administration tips:
Maximum daily dose: Product labeling in some regions allows up to 400 mg/day for adults, but regulators in parts of the world advise lower maximums (for example, 100 mg/day) due to QT prolongation concerns. Follow your local guidance and your prescriber’s instructions. Use the smallest effective dose for the shortest necessary duration.
Atarax is generally well-tolerated when used as directed, but certain conditions and circumstances require careful consideration and monitoring.
Practical self-care tips:
Do not use Atarax if any of the following apply to you:
Use is generally not recommended or requires specialist guidance in:
Most side effects are dose-related and improve as your body adjusts or if the dose is lowered. Contact your healthcare provider if side effects persist or become troublesome.
Common side effects:
Less common side effects:
Serious side effects (seek medical attention immediately):
If you suspect a severe reaction or overdose, contact emergency services right away.
Hydroxyzine’s sedative and anticholinergic actions increase the risk of interactions with many common medicines and substances. Provide your clinician with a complete list of prescription drugs, over-the-counter products, vitamins, and herbal supplements.
Notable interactions include:
Avoid alcohol while taking Atarax. If you are prescribed medications known to affect heart rhythm, ask your clinician whether baseline or follow-up ECG or electrolyte checks are appropriate.
If you miss a dose, take it as soon as you remember unless it is near the time of your next scheduled dose. If it is close to the next dose, skip the missed dose and resume your regular schedule. Do not double doses to make up for a missed dose. For bedtime use, if you forget to take it and it is already very late, it may be safer to skip to prevent morning grogginess.
Signs of overdose may include extreme drowsiness, confusion, agitation, hallucinations, tremors, seizures, very fast or irregular heartbeat, fainting, or breathing suppression. Young children and older adults are at heightened risk of severe effects. If overdose is suspected, call emergency services or poison control immediately. Do not wait for symptoms to worsen.
Store Atarax at controlled room temperature, ideally 68–77°F (20–25°C). Short excursions between 59–86°F (15–30°C) are typically acceptable. Keep tablets or liquid tightly closed, protected from moisture and excessive heat, and away from direct light. Do not store in a steamy bathroom. Keep out of reach and sight of children and pets. Do not use past the expiration date; ask your pharmacist how to dispose of unused medication safely.
Atarax (hydroxyzine) is a prescription-only medication in the United States. It is FDA-approved for several indications, including symptomatic relief of anxiety and tension and for pruritus due to allergic conditions. Because hydroxyzine can cause significant sedation, impair driving, and interact with other medications or heart rhythm, professional evaluation and ongoing clinical oversight are required.
Key points about purchasing Atarax in the U.S.:
HealthSouth Rehabilitation Hospital of Texarkana offers a legal and structured solution for acquiring Atarax without a formal prior prescription in hand. Through compliant clinical pathways, patients can undergo an appropriate evaluation by a qualified provider, and if hydroxyzine is deemed suitable, dispensing is coordinated in accordance with federal and state regulations. This model does not bypass medical oversight; it integrates it, ensuring safety screening for interactions, contraindications, and heart rhythm risks while improving access to care.
Bottom line: Buying hydroxyzine from unauthorized sources or without clinician oversight is unsafe and may be illegal. Use licensed healthcare channels to ensure appropriate dosing, monitoring, and product quality.
This material is for educational purposes only and is not a substitute for personalized medical advice, diagnosis, or treatment. Always consult a licensed healthcare professional before starting, stopping, or changing any medication. Seek immediate medical attention for signs of a severe allergic reaction, overdose, or life-threatening symptoms. Medication availability, approved indications, dosing limits, and safety warnings can vary by country and jurisdiction; follow your local medical guidance and your prescriber’s instructions.
Atarax (hydroxyzine hydrochloride) is a first-generation antihistamine used to relieve anxiety, itching from allergies or hives (urticaria), nausea, and as a premedication for procedures due to its sedative and antiemetic effects.
It blocks H1 histamine receptors and has anticholinergic and sedative properties; in the brain it dampens histamine-driven arousal, which can reduce anxiety and promote sleep.
It usually starts to work within 15 to 60 minutes, with peak effect around 2 hours after a dose.
Effects typically last 4 to 6 hours, though sedation can persist longer; the elimination half-life averages about 20 hours in adults and may be longer in older adults.
Follow your prescriber’s directions; many guidelines limit adult dosing to a maximum of 100 mg per day (divided), using the lowest effective dose for the shortest time due to QT prolongation risk.
Typical regimens use 10–25 mg up to three or four times daily, not exceeding guideline-recommended maximums; dosing varies by region and patient factors, so use as prescribed.
Yes, its sedating antihistamine effect can help with sleep onset, but it is not a first-line long-term insomnia treatment; prioritize sleep hygiene and consult a clinician for chronic insomnia.
Drowsiness, dry mouth, dizziness, blurred vision, constipation, and urinary retention; some people may experience headache or confusion, particularly at higher doses or in older adults.
Hydroxyzine can prolong the QT interval and, rarely, trigger torsades de pointes; risk is higher with existing heart disease, electrolyte abnormalities, high doses, or when combined with other QT-prolonging drugs.
Avoid or use caution in people with known QT prolongation, recent heart attack, significant electrolyte disturbances, narrow-angle glaucoma, enlarged prostate/urinary retention, severe liver or kidney disease, sleep apnea, and in older adults.
It is not an addictive drug and does not cause dependence like benzodiazepines, but tolerance to sedation can occur and abrupt cessation can reveal underlying symptoms.
It is used in pediatric patients for itching and sometimes nausea or premedication; dosing is weight-based and must be determined by a clinician due to sedation risk and potential paradoxical excitation.
Avoid driving or hazardous tasks until you know how it affects you; it commonly causes drowsiness, slowed reaction time, and impaired coordination.
Alcohol, opioids, benzodiazepines, sleep medicines, antipsychotics, some antidepressants, macrolide or fluoroquinolone antibiotics, methadone, and other QT-prolonging or sedating drugs can increase risks; strong CYP3A4 inhibitors may raise levels.
If you miss a dose and it’s close to the next, skip it; don’t double up. Overdose can cause severe drowsiness, agitation, confusion, tachycardia, seizures, and heart rhythm issues—seek emergency care.
No; alcohol intensifies sedation, impairs coordination and judgment, and can raise the risk of respiratory depression and dangerous heart rhythm changes.
Avoid in the first trimester when possible due to limited human data and concerning animal findings; in later pregnancy it may still cause neonatal sedation—discuss safer alternatives and timing with your obstetrician.
Hydroxyzine can pass into breast milk and may sedate or irritate the infant and reduce milk supply; if needed, use the lowest effective dose short term and monitor the baby, or consider alternatives such as cetirizine.
It is sometimes used preoperatively for sedation and nausea, but after surgery it can compound sedation with opioids and anesthetics; only take it if the surgical team approves and monitors for breathing and rhythm effects.
Use with extra caution and lower doses (often half of adult maximums) because of heightened sensitivity to anticholinergic effects, confusion, falls, and QT prolongation; many geriatric guidelines discourage routine use.
Dose reductions and careful monitoring may be needed because clearance is reduced; discuss risks and safer alternatives with your clinician.
Sedation can worsen breathing problems and airway obstruction; use cautiously or avoid, especially at night, and only under medical supervision.
Both can cause sedation, dizziness, and impaired cognition; combining may increase these effects and raise the risk of accidents—avoid or use only with medical guidance.
Both are sedating first-generation antihistamines; hydroxyzine often provides stronger anxiolytic and antipruritic effects with similar anticholinergic side effects, while diphenhydramine is commonly used for allergies and as an OTC sleep aid.
Cetirizine (a metabolite of hydroxyzine) is a second-generation antihistamine that causes less drowsiness and is preferred for daytime allergy control; hydroxyzine is stronger but more sedating and typically reserved for itching or anxiety.
Levocetirizine is less sedating and better suited for long-term allergic rhinitis; hydroxyzine offers greater sedation and anxiolysis but more anticholinergic burden and QT risk.
Both are potent first-generation antihistamines; promethazine is often used for nausea and motion sickness but carries similar sedation and anticholinergic risks, while hydroxyzine is favored for anxiety and itching—choice depends on the primary symptom and safety profile.
Doxylamine is an OTC sleep aid with anticholinergic effects; hydroxyzine can aid sleep but is prescription-only and more often chosen when itching or anxiety are also present. Neither is ideal long term for insomnia.
Meclizine is typically preferred for motion sickness due to a favorable balance of efficacy and sedation; hydroxyzine can help but is more sedating and usually used for itching or anxiety.
Chlorpheniramine can be somewhat less sedating at standard doses, though still a first-generation antihistamine; hydroxyzine tends to be more sedating and more effective for anxiety and pruritus.
Cyproheptadine is antiserotonergic and sometimes used for appetite stimulation and migraine prophylaxis; hydroxyzine is used for anxiety and itching. Both are sedating with anticholinergic effects; choice hinges on the clinical goal.
Yes, both are hydroxyzine salts (Atarax is hydrochloride; Vistaril is pamoate). Clinical effects are similar; dosing differs by formulation, so follow the specific product label.
Second-generation options (cetirizine, levocetirizine, fexofenadine, loratadine) are first-line for chronic urticaria due to less sedation; hydroxyzine may be added at night for breakthrough itching if safe.
Loratadine is minimally sedating and preferred for daytime allergy symptoms; hydroxyzine is more sedating and better reserved for nighttime itching or short-term anxiety.
Fexofenadine causes much less drowsiness and has a favorable safety profile for long-term allergy control; hydroxyzine has more sedation and anticholinergic effects and should be used short term when its added benefits are needed.
