Hydroxyzine And Alcohol
Written by: THE BALANCE
Medically reviewed by Dr. Sarah Boss, MD
Last updated: January 19, 2026
Fact checked
Quick Summary
  • Hydroxyzine, known as Vistaril or Atarax, is a medicine that helps with allergies, nausea, anxiety, and trouble sleeping.
  • It works by blocking histamine, the chemical that causes allergic reactions, and also calms the brain.
  • Although Hydroxyzine is safe when used correctly, it can be dangerous when mixed with alcohol.
Reading time: 13 min

Hydroxyzine, known as Vistaril or Atarax, is a medicine that helps with allergies, nausea, anxiety, and trouble sleeping. It works by blocking histamine, the chemical that causes allergic reactions, and also calms the brain. Doctors often prescribe it because it helps people relax and sleep better.

Although Hydroxyzine is safe when used correctly, it can be dangerous when mixed with alcohol. Both slow down the brain and body. When taken together, they can cause extreme drowsiness, confusion, poor balance, slow breathing, or even heart problems. If this mix continues for a long time, it can also damage the liver and lead to dependence.

At Balance Rehab Clinic, we help people who unknowingly mix medications with alcohol. Many patients are unaware that combining Hydroxyzine and alcohol can harm their body and mind. Learning how these two substances interact can help prevent health risks and keep you safe.

Key Takeaways

• Hydroxyzine (Vistaril, Atarax) treats anxiety, allergies, and nausea but can cause dependence with long-term use.
• Combining Hydroxyzine with alcohol increases sleepiness, confusion, and the risk of heart or breathing issues.
• Long-term use of both can harm the liver and lead to addiction.
• Avoid alcohol completely while taking Hydroxyzine to stay safe.
• Balance Rehab Clinic provides safe detox and treatment programs for people struggling with prescription or alcohol misuse.

Related: Gabapentin and Alcohol

Hydroxyzine is an H1 antagonist drug, which blocks histamine H1 receptors. These receptors regulate multiple functions in our body. Therefore, altering and blockage of H1 receptors can produce sedative, anticholinergic, and anxiolytic effects.

This means that Hydroxyzine can successfully treat symptoms like depression, anxiety, panic, and insomnia, along with allergies. 

Hydroxyzine pills directly inhibit the root cause of the allergic reaction, i.e., histamine.

Different Forms of Hydroxyzine

It is available in two different forms. Hydroxyzine HCL is used to treat itching and allergies. On the other hand, Hydroxyzine Pamoate is commonly prescribed to patients with symptoms of nausea and vomiting. 

Now you must be thinking about what’s the difference between these two. Well, there is a structural and composition change in both. 

Most importantly, the pamoate version can cross the blood-brain barrier (BBB). Hence, it produces different side effects as compared to Hydroxyzine HCL. 

Hydroxyzine HCL is a drug of choice for histamine-mediated pruritis, chronic urticaria, and atopic dermatosis.

Histamine is a potential mediator of the defensive mechanism. It also induces inflammation by activating specific cytokines. Our white blood cells (WBCs) circulating in the vessels detect change and signs of inflammation, resulting in histamine secretion. 

Additionally, histamine can act as a neurotransmitter and send signals via nerve cells—excessive histamine results in allergic reactions.

The route of administration varies for both forms, although it is either oral or parental. Hydroxyzine HCL can be ingested in tablet form or into the vein by a syringe. Besides that, Hydroxyzine Pamoate is available in suspension and capsules. 

Brand Names for Hydroxyzine

Before we get into further details about Hydroxyzine pills, let us talk about different brand names. 

Hydroxyzine HCL form is available with the name: 

  • Atarax 
  • Orgatrax
  • Hy-Pam25

Whereas the pamoate version is known as:

  • Vistaril
  • Equipose
  • Paxistil
  • Masmoran

Onset and Half-Life of Hydroxyzine

The onset is 15-30 minutes and lasts for 6 hours inside the body. The injectable form has a higher beginning as they are directly administered into the blood. 

Moreover, the onset depends upon the dose along with several other factors. The half-life of Hydroxyzine is different in adults, the elderly, and kids. It lasts around 20 hours in adults, 7.1 hours in children, and 29 hours in the elderly.

The medication which is used to treat anxiety and depression is generally habit-forming. However, unlike other anxiolytic drugs, Hydroxyzine has less addiction potential.

Benzodiazepines and other anxiolytic agents are highly addictive. We cannot neglect the fact that overuse or misuse of Hydroxyzine can also form dependency and addiction.

Xanax and other benzodiazepines alter the neurotransmitter levels in our brain. Moreover, these produce a euphoria effect. A patient feels like this is the best and the happiest time of his day. He starts craving the drug more and more. However, if you combine Hydroxyzine and alcohol, it can be addictive. Hydroxyzine with alcohol abuse is very common.

Typical symptoms of alcohol abuse are frequently drinking more, wishing to quit all the time, developing a tolerance, withdrawal symptoms appearing quickly when drinking is stopped for few days.

Common addictions regarding Hydroxyzine are:

  • Vistaril and alcohol
  • Atarax and alcohol. 

Almost 40% of drug-related emergencies in the US are due to alcohol abuse. Nowadays, Hydroxyzine alcohol abuse is on the rise. 

Firstly, it starts with dependency. You cannot seem to miss a dose and live a peaceful life. Panic and anxiety attacks start to rise until you pop a pill. 

Many people do not realize the addiction, and other abusers do not accept it. Although, once you start using the Hydroxyzine pills without a doctor’s prescription. It is the initial step to develop an addiction. 

Your body needs Hydroxyzine pills to get through a day. If you fail to pop a pill, withdrawal symptoms start appearing. 

In contrast, if your doctor has prescribed you benzodiazepine to treat anxiety and addiction is developing. Your doctor can switch to Hydroxyzine. 

No, Hydroxyzine pills alone cannot get you high. However, if you are abusing Hydroxyzine and alcohol altogether, it can get you high. 

Hydroxyzine pills overdose can get you tired, exhausted, unconscious, confused, and drained out. It interacts with alcohol and increases the symptoms. 

Some people find it difficult to focus and concentrate while being high in Hydroxyzine with alcohol. So, Vistaril and alcohol do not go together, and you should avoid alcohol while on Vistaril. The same goes for Atarax and drink.

Moreover, do not take more Hydroxyzine pills by yourself. The doctor recommends you the dose depending upon multiple reasons. 

As mentioned above, Vistaril’s half-life is generally 20 hours. However, many factors can alter this time.

Here are the factors which affect the extended stay of Vistaril in our system.

  • Dose: it determines how long Vistaril will stay in our system. For example, if 25 mg is prescribed to treat anxiety, it stays in the body for 20 hours. Although, doses above 25 mg will give rise to overdose symptoms and take longer in the body.
  • Route of administration: the levels of Vistaril are at the peak after intravenous injection. Contrarily, it takes Vistaril tablets 20-25 minutes to reach maximum capacity. 
  • Dehydration: low fluids or exsiccosis means the concentration will be much higher than the expectations. 
  • Chronic usage: when you are taking doses for a long time. The half-life increases, and it takes more time to eliminate from the body. 

A combination of Vistaril and alcohol can be harmful to health. Alcohol increases the effects of Hydroxyzine pills. Therefore, the risks of severe side effects are more common.

The side effects which suppress and inhibit the nervous system are more prone to occur due to Atarax and alcohol overuse. You should not be drinking alcohol in any form while being treated by Hydroxyzine. 

Read Also: Dual Diagnosis Executive Rehab Center Mallorca

Note: those who first used alcohol before the age of 15 are seven times more prone to be addicted. 

Alcohol is also abused with many central nervous systems (CNS) depressants. The Hydroxyzine and alcohol death ratio is significantly increased since then. 

The most typical form of alcohol that is readily available are:

  • Beer.
  • Wine.
  • Liquor.

No wonder Hydroxyzine is an exceptional drug. It has the lowest addiction potential. However, Hydroxyzine with alcohol can cause mild or severe side effects. 

Hydroxyzine overdose with alcohol, opioids, and opiates can develop symptoms like blurred vision, lack of concentration, lack of coordination.

If you were wondering, “does Hydroxyzine get you high, or does Hydroxyzine causes weight gain.” Well, the answer is yes, if you are using Hydroxyzine HCL, and alcohol.

Alcoholism directly damages the liver, and eventually, it leads to cirrhosis. It is a reversible, end-stage liver disease. 

People who are addicted to abuse may wish to stop it but cannot achieve their goals. The side effects of Hydroxyzine alcohol are the same in men and women.

Short-Term Side Effects

Some of the common and short-term Vistaril and alcohol side effects are mentioned below:

  • Constipation.
  • Confusion.
  • Dry mouth.
  • Muscle tremor.
  • Low blood pressure.
  • Sleepiness.
  • Fatigue.
  • Weakness.

Long-Term Side Effects

The mild Vistaril and alcohol side effects may reside within few days of quitting it. However, if you fail to do so, the following serious side effects can start appearing. 

  • Cardiac symptoms: the rhythmic contraction of heart muscles create a wave-like pattern which you can see on an electrocardiogram (ECG). Abusing Hydroxyzine with alcohol increases QT interval. 

This condition decreases the strength of heart muscles and disturbs the rhythm. You can faint anytime and have a fluttering pain in the chest. 

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  • Shortness of breath: while inducing allergic reaction, it can also cause hypoxia. Allergic reaction narrows the bronchioles resulting in low oxygen exchange in the alveoli. 
  • Severe sleepiness: if you have overdosed on Atarax and alcohol, avoid going out or driving. It causes extreme drowsiness, and you can sleep anywhere in broad daylight. 
  • Low blood pressure: overdosing on Hydroxyzine pills alone does not cause severe low BP. Although, Hydroxyzine overdose with alcohol lowers your blood pressure. 
  • Cold skin: the blood supply to the skin reduces due to low BP. 
  • Sedation: Hydroxyzine interactions with alcohol makes you feel highly sedated. A person does not feel pain or sense where he is.
  • Hallucination: it is a classical sign of alcoholism. The person starts seeing objects which are not there due to the defect in all five senses. 
  • Severe weakness and weight loss: Hydroxyzine HCl and alcohol are detoxified in the liver. Due to excessive intake, it starts damaging the liver. All the mechanisms of metabolism are regulated in the liver. Therefore, the person becomes extremely thin and weak. 
  • Allergic reaction: no wonder Hydroxyzine is primarily used to treat allergies. But abusing Vistaril and alcohol can cause rash, itching, and flushing. 

If you ever see anyone unconscious or conscious with these symptoms. Seek immediate help and save a life. 

It is not safe to use alcohol with Vistaril as you already know Hydroxyzine interactions with alcohol alter the symptoms. 

Before we get to the dangers of Hydroxyzine overdose with alcohol, let’s have a look at the risk factors of mixing Hydroxyzine and alcohol:

  • Allergy: Do not take Vistaril and alcohol if you are allergic to any Hydroxyzine. 
  • Age: Doses are different for children, so do not give your medication to any child. 
  • Hypersensitivity: Do not take Atarax and alcohol if you already have a hypersensitivity medicated allergy. 
  • Nursing mothers should not take Vistaril with alcohol
  • Machine Operations: Do not operate heavy machinery, as it can cause CNS suppression leading to drowsiness and fainting. 
  • Glaucoma, Benign Prostate Hyperplasia, or respiratory disease: Do not abuse Hydroxyzine with alcohol if you have any of these problems. 
  • Pregnancy: Alcohol is highly prohibited in pregnancy. It can cause congenital problems or even abortion if abused in the 1st trimester. 

If you mix Vistaril and alcohol, it can cause the following dangers: 

  • Seizures: a seizure is the involuntary excitation of nerve cells that excite muscles in our body. It can affect the whole body or some part of it. Besides that, alcohol damages the liver, and the toxins are released in the blood. Certain toxins are also capable of crossing the blood-brain barrier and damage brain cells. 
  • Dementia: it is another classical sign of alcoholism. In dementia, a person sometimes fails to recognize family members and friends. He can be abusive and irrational. 

He is unable to remember anything new and only thinks about past time. 

  • Heart problems: mixing Vistaril and alcohol can cause arrhythmia. You can die if the QT interval is too prolonged. 
  • Liver and kidney problems: Hydroxyzine and alcohol are metabolized through the liver and excreted by the kidney via urine. Mixing Vistaril and alcohol damages the liver and kidney simultaneously. 

If you are on any medication, using alcohol with it can be very dangerous. You must know that almost every drug is metabolized in the liver, and drink directly damages the liver.

Chronic alcoholism leads to a fatty liver which converts into cirrhosis with time. Hydroxyzine interacts with alcohol; it causes prolong QT interval, which can result in sudden cardiac death. 

In the early 1960s, Hydroxyzine was prescribed to patients fighting alcohol addiction. However, scientists did not get satisfactory results, and it was stopped suddenly. 

Related: The Dangers of Prozac And Alcohol Interaction

Additionally, alcohol enhances the side effects; for example, if you mix opiate with alcohol, it causes severe respiratory depression and lungs collapse. 

So, Hydroxyzine with alcohol might not be a good idea. You may consult your doctor if you are unable to get your hands off a glass of wine.

The onset of Hydroxyzine tablets is 15-30 minutes, and the half-life is almost 6 hours. It stays inside our system for 6 hours. 

If you drink alcohol within 6 hours of Hydroxyzine, it will cause the above-listed side effects and complications. The mentioned time is for limited doses. 

However, if you are an addict, there is a considerable risk that your liver is damaged, and the metabolism is not perfect. Therefore, Hydroxyzine can still be in your system for a long time. The best way is to consult your doctor before it gets too late. 

Hydroxyzine is an excellent fast-acting drug to treat anxiety in both adults and kids. It is usually prescribed for a short period. 

Unfortunately, Hydroxyzine and alcohol abuse are seen in many people. Many people come to ER due to alcohol abuse symptoms. Hydroxyzine and alcohol abuse death graph is also rising to an alarming level. 

Luckily, we can significantly impact society by spreading awareness regarding it before things get out of hand. We are already fighting a war against addiction and cannot afford another ally on the opposite side.

Mixing different drugs and abusing them is now a cultural thing that should be stopped! Reach out for our luxury rehab treatment program.

FAQs

Does Hydroxyzine cause weight gain? 
Well, Hydroxyzine is not known to cause weight gain. Although, if your liver is already damaged due to other conditions or mixing Hydroxyzine with alcohol, it can cause weight gain. 
Please consult your doctor and tell them about all your addictions and habits. He will suggest the best routine and lifestyle for you. 

Can Hydroxyzine cause sudden death? 
Hydroxyzine alters the rhythmic contraction in myocardial muscles by prolonging the QT wave, which is formed when electrical impulses are conducted from the Sino-atrial (SA) node to the myocardial muscles. 
Prolong QT results in decreased contraction, and low blood is supplied to the brain. As a result, it can completely shut down, leading to sudden cardiac death.

Can you overdose on Hydroxyzine with alcohol?
Hydroxyzine interacts with alcohol, and mixing can result in severe complications like coma, sudden death. Chronic overdose of Hydroxyzine and alcohol can cause hepatic encephalopathy when too many toxins start pilling up in the brain. 

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