How Long It Takes Hydroxyzine to Work (Plus 4 More Pharmacist-Backed Tips for Taking It)

Hydroxyzine (Vistaril) is a medication that can help relieve itching caused by allergies. It’s unique from other allergy medications because it can also treat anxiety. It’s typically taken on an as-needed basis, up to four times a day.

Hydroxyzine is a prescription-only antihistamine that works similarly to diphenhydramine (Benadryl). There are two versions of hydroxyzine: hydroxyzine hydrochloride and hydroxyzine pamoate. They both share the same FDA-approved uses and dosages. Many people find no significant difference between how these two versions work. But you or your healthcare provider may prefer one over the other.

If you’re taking hydroxyzine for the first time, you’ve likely discussed it with your healthcare provider. But it’s typical to have more questions after you get your prescription. So if you’re wondering how long it takes hydroxyzine to work or when to take it, you’ve come to the right place.

1. How long does it take for hydroxyzine to work?

It takes hydroxyzine about 15 to 30 minutes to start working. This makes it helpful for quickly managing anxiety or itching. It may take about 2 hours to experience hydroxyzine’s full effects. And it may start to wear off after about 4 hours.

On a related note, hydroxyzine’s side effects can occur quickly as well. Side effects like dry mouth and drowsiness often start to happen around the same time it starts working — about 15 to 30 minutes after a dose.

2. What time should I take hydroxyzine?

Drowsiness is a common side effect of hydroxyzine. So it’s best to take it about 15 to 30 minutes before bed if you’re only taking it once a day. This way, drowsiness happens when it's time to sleep.

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However, hydroxyzine can be prescribed up to four times per day. And this could cause daytime drowsiness, which could be problematic. If you’re prescribed daytime hydroxyzine doses and drowsiness is an issue, talk to your healthcare provider about whether taking lower daytime doses is an option for you. Lower doses are less likely to cause sleepiness.

With regular, consistent use of hydroxyzine, drowsiness may become less noticeable for some people. But don’t drive or perform other tasks that require alertness until you know how this medication affects you. If drowsiness from hydroxyzine is too bothersome, let your provider know. The medication may not be the best option for you.

3. Can I take hydroxyzine for sleep?

Possibly, but it’s not a preferred medication for sleep. As discussed above, hydroxyzine commonly makes people tired. For this reason, it’s sometimes prescribed off-label for sleep problems, such as insomnia. Typically, hydroxyzine would be considered if other sleep aids weren’t working or well tolerated.

A review of clinical studies showed varying results of hydroxyzine’s usefulness for insomnia. Higher doses of hydroxyzine may be helpful for improving sleep quality when used for a short time (8 weeks or less). However, its long-term safety and effectiveness haven’t been well studied.

4. Should I take hydroxyzine with food?

Hydroxyzine can be taken with or without food. Eating won’t affect how the medication works in the body. But it’s best to avoid drinking alcohol when taking hydroxyzine. This combination can lead to excessive drowsiness.

5. Should I take hydroxyzine separately from other medications?

Yes, hydroxyzine should be separated from certain medications. Here, we’ll discuss two notable examples of medications that can interact with it. But be sure to check out our hydroxyzine interaction guide for more information.

As discussed earlier, hydroxyzine can make you sleepy. So you might want to take it at a different time from other medications that cause drowsiness, such as opioids like oxycodone or muscle relaxers like cyclobenzaprine. Hydroxyzine’s effects can last for about 4 to 6 hours. Depending on your medication schedule and how often you’re taking hydroxyzine, you may be able to sufficiently space out your other medications from it.

Hydroxyzine also has anticholinergic properties. This means it can cause side effects like dry mouth, blurry vision, and constipation. It can also cause memory problems and confusion, especially if you take it with other anticholinergic medications. Older adults may be more sensitive to these interactions and their potential complications. Your healthcare provider may have you separate hydroxyzine from these medications to lower the risk of these side effects. Or they may suggest changing one of your medications to avoid problems.

It’s important to provide an updated medication list to your healthcare provider and pharmacist. They can review it and let you know if your medications are safe to take together.

Tips for how to save money on hydroxyzine

Hydroxyzine is available as a lower-cost generic medication. GoodRx can help you save over 60% off the average retail price. Hydroxyzine hydrochloride’s price at certain pharmacies is as low as $5.41 with a free GoodRx discount. Hydroxyzine pamoate’s price at certain pharmacies is as low as $8.54 with a free GoodRx discount.

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Written by:

Victoria Dadebo, PharmD, BCPS

Victoria Dadebo is a freelance pharmacy writer who began contributing to GoodRx in 2022. She has experience in both community and hospital settings, and she is furthering her pharmacy training to specialize in mental health.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

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