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Can You Cut Hydroxyzine in Half? How To Take the Drug Properly

Can You Cut Hydroxyzine in Half? How To Take the Drug Properly

If you’ve been grappling with wakeful nights and longing for restorative sleep and brighter mornings, your doctor might recommend hydroxyzine—a medication that can be effective in treating sleep disorders. 

You may start your treatment confidently but soon realize that the dose might be a bit too strong, leading you to consider reducing the dose by splitting the tablet. But can you cut hydroxyzine in half? We’ll explain the potential risks and benefits of splitting this medicine as well as how to do it safely.

Understanding Hydroxyzine’s Mechanism of Action for Proper Dosing

Hydroxyzine is a first-generation antihistamine typically prescribed to individuals with allergic reactions, anxiety, and tension. The medication blocks the action of histamine, relieving symptoms like itching, sneezing, runny nose, and watery eyes.

The drug also has anticholinergic and sedative properties. It depresses activity in certain regions of the central nervous system and induces a calming effect, which can help you fall and stay asleep.

The drug is FDA-approved and doesn’t carry the risk of addiction, so it’s not considered a controlled substance. Check out the medications’s basic characteristics in the table below:



Active component

Hydroxyzine dihydrochloride

FDA approval


Controlled substance


Addiction risk



Tablet, liquid, capsule

Available doses

10 mg, 25 mg, 50 mg, 100 mg

Pregnancy category

C (risk can’t be ruled out)

How long should you take it?

3–4 months maximum

Source: Ron Lach

Is It OK To Cut Hydroxyzine in Half?

It’s generally safe to cut hydroxyzine tablets in half. They’re not extended-release, so splitting them shouldn’t affect how your body absorbs the medication. Still, you should consult your doctor before altering the way you take this medicine.

To understand the implication of splitting hydroxyzine, consider the following:

  1. Why do people cut pills in half?
  2. Risks and benefits of pill-splitting

Why Do People Cut Pills in Half?

People cut pills in half for various reasons, such as:

  • To make the pills easier to swallow
  • To adjust the dose as directed by their healthcare provider
  • To reduce the total claims where insurers cap the maximum compensation they can receive

Risks and Benefits of Pill-Splitting

Pill-splitting carries specific risks and benefits. The primary advantage is cost-saving because splitting a higher-dose pill into two lower-dose pills can be economical.

However, pill-splitting can lead to incorrect dosing if the pill isn’t cut evenly. Some pills aren’t even safe to cut in half—for example, extended-release tablets shouldn’t be split as this can lead to the entire dose being released at once and cause unwanted reactions. Before cutting your pills, you should talk to your healthcare provider.

Does Cutting Affect Hydroxyzine’s Effectiveness for Sleep?

Splitting a hydroxyzine tablet doesn’t impact its effectiveness in promoting sleep—the medication continues to function as intended, providing its antihistamine and sedative effects. Still, the drug may leave your system sooner than expected this way.

If you experience unwanted reactions after cutting it in half—such as waking up in the middle of the night—you should inform your healthcare provider immediately. They’ll adjust the dose to ensure it’s safe and effective for you.

Factors To Consider Before Splitting Hydroxyzine

Before cutting hydroxyzine in half, you should consider the following factors:

  1. The type of hydroxyzine tablet
  2. The dose you’re taking
  3. Your doctor’s instructions

The Type of Hydroxyzine Tablet

Hydroxyzine is available in two formulations:

  1. Hydroxyzine pamoate (Vistaril)
  2. Hydroxyzine hydrochloride (Atarax) 

As long as you make sure to stick to your doctor’s instructions, both types are suitable for splitting in half. 

The Dose You’re Taking

Hydroxyzine is available in four doses:

  1. 10 mg
  2. 25 mg
  3. 50 mg
  4. 100 mg

The prescribed dose can influence your decision to split the tablets. For instance, if only the 100 mg dose is available and you need a 50 mg dose, your doctor may suggest splitting it.

Your Doctor’s Instructions

You should only split hydroxyzine if your doctor recommends it. Even then, you should only take the medicine at the recommended time to ensure safe and effective dosing.

Doctors typically recommend taking hydroxyzine at least 60 minutes before going to bed to allow the drug to kick in on time. Regardless of your dose, you should allocate at least seven hours to sleep for the drug’s effects to wear off naturally.

The Impact of Cutting Hydroxyzine on the Dosage

Cutting a hydroxyzine tablet in half reduces the dose. If you split a 100 mg tablet, you’ll get two halves, each containing about 50 mg of hydroxyzine. The actual quantity of the active substance in each half can vary due because making a perfectly even cut is difficult, leading to slight variations in the medication you receive per dose.

To ensure safe and accurate dosing when splitting hydroxyzine, you should use a pill splitter—this device can help ensure that each piece is as close to half of the dose as possible. This medicine isn’t scored, so you should ask a healthcare professional about the best splitting spot.

Source: cottonbro studio

Alternatives to Cutting Hydroxyzine in Half

If cutting hydroxyzine in half isn’t an ideal option, your healthcare provider may recommend the following:

  1. Lower doses of the drug
  2. Other medications for insomnia

Lower Doses of the Drug

In case the dose you’re currently taking is too high, consider a lower dose. For example, if you’ve been experiencing daytime drowsiness after taking the 50 mg tablet the previous night, your doctor may recommend switching to the 25 mg pill.

Hydroxyzine carries the risk of side effects, and while cutting the tablet may not cause problems, overdosing may cause the following reactions:

The list above isn’t exhaustive. Patients who experience unexplained physical or cognitive changes should inform their healthcare providers immediately.

Other Medications for Insomnia

If your doctor decides that cutting hydroxyzine may not be effective for you, they may recommend other options. Check out common hydroxyzine alternatives in the table below:

Hydroxyzine Alternative



Can be used in the short-term treatment of insomnia stemming from anxiety disorders


Often used for temporary relief from sleeplessness due to minor aches and pain


A benzodiazepine used to treat sleep problems due to anxiety or stress


Can be used to treat sleep issues due to anxiety, seizures, and muscle pain


Can be used to treat insomnia caused by depression 


An antihistamine that can also be used as a sleep aid in the short-term


A beta-blocker used off-label to manage sleep disorders and symptoms of anxiety


Can be used in the short-term treatment of insomnia due to anxiety and depression


A muscle relaxant used to treat sleeplessness due to muscle injury


Sometimes used off-label in the treatment of insomnia, particularly in people with chronic pain


Used to treat chronic insomnia

Several complex factors can trigger insomnia, including stress, poor sleep habits, or underlying health problems. Hydroxyzine and other drugs alone may not provide a lasting solution, so you should see a sleep expert who can design a treatment tailored to your specific sleep issue and medical history.

This may be easier said than done because sleep doctors are hard to find in the U.S., and you may have to wait for a while before getting an appointment. The exciting news is that Kick, a telemedicine performance clinic, can connect you with top-tier sleep experts within a day.

Source: Nitin Khajotia

Kick—Your Best Night’s Sleep Designed by Experts

Designed by Dr. Alex Dimitriu, a Stanford sleep expert, Kick’s sleep program entails a treatment plan designed specifically for you. When you join the program, you can expect:

  • Personalized treatment—You receive two trial medications tailored to your sleep issue and health status
  • Ongoing consultation—Our expert will schedule regular check-ins to monitor your progress and adjust the treatment if necessary
  • Cognitive behavioral therapy for insomnia (CBT-i) coaching—You get valuable tips on cultivating healthy sleep practices through ongoing coaching
  • Cost-effective approach—As per our Doctor Guarantee, you don’t pay for the initial consultation if our team decides the program isn’t the best fit for you
  • Convenience—You can choose between doorstep delivery and local pharmacy pickup for receiving your medication, making the process entirely discreet

How To Join Kick

Kick’s sleep program has helped many patients rediscover their best night’s rest. The glowing feedback on Trustpilot is a testament to our program’s effectiveness:

“Great service and quick responses. They helped me when other doctors were more dismissive about my health concerns. Highly recommended :).”

Jason W., U.S.

To benefit from Kick’s program, follow these easy steps:

  1. Go to our Sleep Visit page to initiate your 15-minute consultation 
  2. Fill out the required form to help us understand your sleep issue
  3. Add your payment and shipping information

Our expert will review your information and prescribe two trial medications in 24 hours. You’ll take these medications for a week each to prevent developing tolerance to one drug, and the doctor will follow your progress and adjust the treatment accordingly.

Source: Alexandr Polepkin

Precautions When Using Hydroxyzine

When using hydroxyzine, you should consider the following and take the required precautions:

  • Potential interactions with medications—This medicine may interact with other medications, including over-the-counter drugs and herbal supplements. Before using this drug, you should inform your healthcare provider about all medicines you’re currently taking
  • Potential interaction with food and other substances—You should avoid consuming alcohol, caffeine, and marijuana while taking hydroxyzine because these substances can contribute to side effects such as drowsiness and dizziness
  • Tolerance and dependence—Long-term use of hydroxyzine can lead to tolerance, so you’ll need higher doses to achieve the same effect. The drug doesn’t carry the risk of addiction, but psychological dependence may occur with prolonged use
  • Pregnant women—Unless given a green light by a healthcare professional, this medication shouldn't be used during pregnancy or when planning to get pregnant
  • Obtaining the medication—Hydroxyzine is a prescription medication. You should only get it through a licensed provider and use it as directed by your doctor
  • Activities requiring alertness—This drug can cause drowsiness. You should avoid activities that require sharp focus, such as driving, climbing ladders, or operating heavy machinery until the effects subside

Following these guidelines will help ensure your hydroxyzine treatment is as effective as possible for improved sleep.

Featured image source: lucas souza