Key takeaways:
Hydroxyzine (Vistaril) is a prescription antihistamine that’s used for the short-term treatment of anxiety and to manage itching. It’s also given as a sedative before and after general anesthesia.
Most adults take between 25 mg and 100 mg of hydroxyzine 3 to 4 times a day (75 mg to 400 mg per day). Children typically take 50 mg to 100 mg per day divided into 3 to 4 smaller doses.
Hydroxyzine is typically only meant for short-term use. Talk to your healthcare team if your symptoms aren’t improving or you need a long-term solution.
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Hydroxyzine (Vistaril) is a first-generation antihistamine that was first approved in 1957. It’s still used today to treat anxiety, itching due to allergies, and to help you relax before and after receiving general anesthesia.
Taking the right amount of hydroxyzine can help you avoid side effects and get the most from this medication. This guide reviews the typical hydroxyzine dosages for adults and children. But you should always follow your prescriber’s instructions, even if they differ from what’s described below.
What dosage forms does hydroxyzine come in?
Hydroxyzine is available in two different salt forms: hydroxyzine pamoate and hydroxyzine hydrochloride. Each type of hydroxyzine is available in different dosage forms:
Hydroxyzine pamoate comes in 25 mg and 50 mg capsules.
Hydroxyzine hydrochloride comes in 10 mg, 25 mg, and 50 mg tablets. It also comes in an oral syrup (liquid) that contains 10 mg of hydroxyzine per 5 mL.
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Both forms of hydroxyzine are approved for the same uses. And the recommended dosages are the same no matter which type of hydroxyzine you’re taking.
Good to know: Hydroxyzine also comes in an injectable form. But since this is typically only used in a hospital setting, it isn’t included in this dosage guide.
What’s the typical hydroxyzine dosage for adults?
The recommended hydroxyzine dosage for adults depends on why you’re taking it. In most cases, you’ll take hydroxyzine 3 to 4 times a day. You can take it with or without food.
Anxiety
For anxiety in adults, the typical hydroxyzine dosage is 50 mg to 100 mg 4 times a day.
Keep in mind that hydroxyzine works quickly, which is why it’s sometimes prescribed for panic attacks. But it can make you feel sleepy — especially at higher doses. And it’s only meant for short-term anxiety relief, it isn’t considered a long-term treatment option.
Itching and chronic hives (Pruritus and chronic urticaria)
Itchy skin is a common symptom of allergic reactions, chronic urticaria (hives), and atopic dermatitis (eczema). For itching and hives, the typical hydroxyzine dosage for adults is 25 mg by mouth 3 to 4 times a day. Similar to anxiety symptoms, it should start to relieve itching within 15 to 30 minutes.
Sedation
To help you relax before surgery, the typical hydroxyzine dosage for adults is 50 mg to 100 mg by mouth before and after general anesthesia.
Sleep issues (insomnia)
Hydroxyzine isn’t FDA approved for sleep, so there isn’t a recommended dosage for this use.
Studies suggest that 25 mg to 100 mg of hydroxyzine at bedtime may help improve sleep, and it’s likely safe for short-term use. But the evidence is mixed as to how well it works. And hydroxyzine may leave you feeling drowsy the next day. So it’s best to check with your prescriber before taking hydroxyzine for sleep or other off-label uses.
What’s the typical hydroxyzine dosage for children?
In children, hydroxyzine is approved to treat the same conditions as adults. However, the dosage in children is usually much lower. Your child’s hydroxyzine dosage will depend on their age and the reason they’re taking hydroxyzine.
Similar to adults, the recommended dose for each condition is the same across all dosage forms (e.g., capsule, tablet, or syrup). Your child can take their hydroxyzine dose with or without food.
Anxiety
For children younger than age 6 years experiencing anxiety, the typical hydroxyzine dosage is 50 mg per day. For children ages 6 and older, the typical hydroxyzine dosage is 50 mg to 100 mg per day. Your child’s total daily hydroxyzine dose should be divided into 3 to 4 smaller doses spread throughout the day.
Itching and chronic hives
For itching and chronic hives in children younger than age 6, the typical hydroxyzine dosage is 50 mg per day. For children ages 6 and older, the typical hydroxyzine dosage is 50 mg to 100 mg per day. Your child’s total daily hydroxyzine dose should be divided into 3 to 4 smaller doses given throughout the day.
Sedation
When used for sedation with general anesthesia, the hydroxyzine dosage is based on your child’s body weight. The typical hydroxyzine dosage is 0.6 mg per kg of body weight by mouth before and after general anesthesia.
Are there any dosage adjustments for medical conditions?
Hydroxyzine is broken down by the liver and removed from your body through the kidneys. Liver and kidney problems can lead to increased hydroxyzine levels in the body. This can raise your risk of side effects, such as sedation and dizziness.
There aren’t any FDA-recommended dosage adjustments for people living with liver or kidney problems. But your prescriber may have you start with a lower dosage as a precaution.
In general, experts recommend avoiding hydroxyzine in adults ages 65 and older. That’s because this age group is more sensitive to the side effects of hydroxyzine and other first-generation antihistamines. If you’re over age 65 and your prescriber recommends hydroxyzine, they’ll likely start you with a lower dosage than usual to help avoid dizziness and falls.
Several hydroxyzine interactions can also increase the risk of side effects. So be sure to discuss your full medical history with your prescriber before starting hydroxyzine. And make sure they have your current list of medications and supplements you take.
What happens if you miss a dose of hydroxyzine?
Since you’ll usually take hydroxyzine multiple times a day, it can be easy to forget your dose. If this happens, take the missed dose as soon as possible. You can then continue with your regular dosing schedule. But if it’s getting close to your next dose, just skip the missed dose.
Never double up on hydroxyzine to make up for missed doses, since this can make side effects more likely. If you have trouble remembering to take your medications, using a pill organizer or a medication reminder app might help. If you aren’t sure how to handle a missed dose of hydroxyzine, contact your prescriber or pharmacist.
What should you do if you take too much hydroxyzine?
If you take an extra dose of hydroxyzine by mistake, it’s unlikely to be an issue. The most common symptom you’ll experience is excessive drowsiness.
But large amounts of hydroxyzine can be more serious. You may experience nausea, vomiting, and uncontrolled shaking. Hallucinations, abnormal heart rhythms, and coma are also possible. To avoid this, don’t take more hydroxyzine than recommended by your prescriber. And keep your medication out of reach and away from children to prevent an accidental overdose.
If you or your child might have taken too much hydroxyzine, contact Poison Control online or by phone at 1-800-222-1222. If you notice any symptoms described above, seek emergency care right away.
How to save on the cost of hydroxyzine
Hydroxyzine is available as a lower-cost generic. GoodRx can help you save over 60% off the average retail price. With a free GoodRx discount:
You can pay as little as $13.50 for 90 tablets of hydroxyzine hydrochloride 50 mg.
You can pay as little as $12.60 for 90 capsules of hydroxyzine pamoate 50 mg.
You can pay as little as $25.45 for 150mL of hydroxyzine hydrochloride 10mg/5mL oral solution.
The bottom line
Hydroxyzine (Vistaril) is a prescription medication that treats conditions such as anxiety, itching, and chronic hives in children and adults. It’s available as capsules, tablets, and an oral syrup.Your hydroxyzine dosage depends on your age and why you’re taking it.
Most adults take 25 mg to 100 mg of hydroxyzine 3 to 4 times a day (75 mg to 400 mg per day). Children’s hydroxyzine dosages are generally much lower — 50 mg to 100 mg per day, divided into 3 to 4 smaller doses. If you have questions about taking hydroxyzine, contact your healthcare team for more information.
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References
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Farzam, K., et al. (2025). Antihistamines. StatPearls.
Kesin Pharma. (2026). Hydroxyzine hydrochloride- hydroxyzine hydrochloride solution [package insert].
MedlinePlus. (2017). Hydroxyzine.
MedlinePlus. (2021). Hydroxyzine overdose.
National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Hydroxyzine. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury.
NuCare Pharmaceuticals, Inc. (2026). Hydroxyzine hydrochloride- hydroxyzine hydrochloride tablet, film coated [package insert].
Patel, D. R., et al. (2018). Pharmacological treatment of anxiety disorders in children and adolescents: a review for practitioners. Translational Pediatrics.
PubChem. (2024). Hydroxyzine. National Center for Biotechnology Information.
Semla, T. P, et al. (2023). American Geriatrics Society 2023 updated AGS Beers Criteria for potentially inappropriate medication use in older adults. Journal of the American Geriatrics Society.
