Does Hydroxyzine Cause Sexual Side Effects?

Erectile dysfunction (ED) is a possible side effect of certain antihistamines. But not all antihistamines are created equal. Some have more side effects than others.

But how common are sexual side effects with hydroxyzine (Vistaril)? Thankfully, they don’t happen frequently. But they are possible.

Does hydroxyzine cause sexual side effects?

It’s unlikely that hydroxyzine will cause sexual side effects. Sexual problems, such as ED and low libido (sex drive), aren’t listed as side effects in hydroxyzine’s labeling. But everyone’s experience is different.

We know that other first-generation (older) antihistamines, such as diphenhydramine (Benadryl), can cause sexual problems. However, there aren’t many studies on whether sexual side effects happen with hydroxyzine. So it’s possible that hydroxyzine may cause sexual problems. But based on the information we have, it’s likely rare.

Good to know: Some research suggests that people with allergies and allergic conditions may be more likely to have sexual problems. So the sexual difficulties you’re having could be linked to allergies (a reason some people take hydroxyzine).

Sexual side effects of hydroxyzine for men

It’s very rare for anyone to have sexual side effects while taking hydroxyzine. But men could potentially have:

• Trouble achieving an erection

• Trouble maintaining an erection

• Priapism (an erection that lasts too long) — more on this rare but serious side effect later

Sexual side effects of hydroxyzine for women

There are no known reports of women experiencing sexual side effects while taking hydroxyzine.

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However, fatigue and drowsiness are common hydroxyzine side effects. These side effects can make it more difficult to do a number of regular activities. If you believe fatigue may be contributing to your sexual issues, let your prescriber know. They may suggest lowering your dosage to help relieve side effects.

How common are sexual side effects with hydroxyzine?

As mentioned above, sexual side effects are probably rare with hydroxyzine. Only a small number of people have reported these issues to the FDA’s Adverse Event Reporting System (FAERS).

FAERS is the FDA’s database for tracking problems people have when taking a medication. It can help the FDA identify safety concerns that weren’t seen during clinical trials. A medication may not have caused a reaction in the FAERS database. But if a large number of people report similar problems, the FDA may look into it further.

Do sexual side effects from hydroxyzine go away?

As discussed, people taking hydroxyzine don't usually experience sexual side effects. So we don’t know for sure how long these issues might last should they happen to you.

However, hydroxyzine’s effects don’t last very long in the body. The medication may start wearing off in as little as 4 hours. Typically, side effects don’t last very long either. If sexual side effects happen, they’re likely to go away on their own after the medication wears off too.

How can you manage sexual side effects from hydroxyzine?

Talk with your prescriber if you’re having sexual problems while taking hydroxyzine. Your prescriber will likely want to evaluate you for a cause and discuss potential treatment options.  Together, you can put together an action plan that works best for you.

EXPERT PICKS: WHAT TO READ NEXT

• What to expect: Read about hydroxyzine’s side effects — from drowsiness to dry mouth — and how to manage them.

• When it takes effect: Hydroxyzine takes about 15 to 30 minutes to start working. Get answers to other commonly asked questions about this antihistamine.

• Other erectile dysfunction causes: Antihistamines are one of several medications that can cause erectile dysfunction.

If your prescriber determines hydroxyzine is the reason for your sexual problems, they may suggest an alternative medication for your symptoms. Many other medications can manage allergies, itching, or anxiety (common reasons people take hydroxyzine).

When to seek emergency care for sexual side effects

There are rare reports of men experiencing priapism after taking hydroxyzine. Priapism is a painful erection that lasts for more than 4 hours. It’s a medical emergency that can result in permanent damage to the penis. Fortunately, it’s very rare with hydroxyzine, and there have only been a few reported cases since the medication’s initial FDA approval.

If you experience an erection that’s painful or lasts for 4 hours or longer, seek emergency medical care.

Is hydroxyzine more likely to cause sexual side effects than other antihistamines?

We don’t know if hydroxyzine is more or less likely than other antihistamines to cause sexual side effects. This type of comparison hasn’t been well studied due to how rarely hydroxyzine causes sexual side effects.

However, we do know that it’s possible for all antihistamines to cause ED. This is likely because the chemical histamine plays a role in achieving and maintaining erections. And antihistamines, such as hydroxyzine, block histamine’s actions in the body.

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Written by:

Kristina D. Carter, PharmD, MBA, MHA

Kristina D. Carter, PharmD, MBA, MHA, has over 25 years of experience working in healthcare. She is registered as a licensed pharmacist in Georgia, Indiana, and Tennessee.

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:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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