You turn in your bed for the umpteenth time, hoping a new cold spot will help you finally fall asleep—annoyingly, to no avail. Counting sheep, ambient sounds, and meditation have all failed to get you more shut-eye, which is why your doctor suggested hydroxyzine as an off-label treatment for sleep.
The medication has proven effective for sleeplessness, but its sedative effects raise other questions—for example, can you drive on hydroxyzine safely? This guide will provide an in-depth answer by examining the drug’s various effects, appropriate doses, and safety precautions.
How Does Hydroxyzine Work?
Hydroxyzine belongs to a class of medications called antihistamines, which are primarily used to treat allergic reactions.
When your body is exposed to an allergen, histamine ties itself to receptors in your blood vessels, making them dilated. This causes allergic reactions like itching, a runny nose, red eyes, and breathing difficulties.
Besides allergies, hydroxyzine is often prescribed for sleeplessness, anxiety, and induced sedation before surgeries. The drug suppresses histamine by binding itself to H1 histamine receptors and blocking them in various cells, including the ones in our respiratory tract, blood vessels, and skin. This results in a calming effect that can help you achieve sleep.
It’s available in the following forms:
The table below contains other basic facts about hydroxyzine:
Can I Drive on Hydroxyzine?
No, you can’t—driving on hydroxyzine is dangerous. The drug’s sedative effects make it an excellent sleep medication, but the accompanying drowsiness and lack of alertness make driving vehicles or operating heavy machinery after taking the medicine hazardous.
The effects of hydroxyzine last around six hours, so you should wait for the drug to wear off before taking the wheel. Since typical insomnia treatments with hydroxyzine involve taking the medication 30 minutes before bedtime, allocate at least seven hours for sleep before driving.
Is Hydroxyzine Safe?
As a drug approved by the Food and Drug Administration (FDA), hydroxyzine is perfectly safe for sleep as long as it’s prescribed by your doctor. You won’t develop a physical addiction to this sedative, unlike with Ativan or other benzodiazepines.
Hydroxyzine isn’t listed as a controlled substance by the Drug Enforcement Administration (DEA), which means the medication doesn’t entail a high risk of dependence and misuse. Plenty of drugs that are classified as controlled substances are also prescribed for sleep issues, but addiction is avoidable as long as you take them according to your doctor’s instructions. Some of those drugs are:
However, the FDA hasn’t confirmed that hydroxyzine is safe for long-term use. The longest clinical study so far involved the use of hydroxyzine for anxiety, and it lasted for four months.
While long-term use shouldn’t lead to physical addiction, chronic intake of hydroxyzine can result in increased tolerance—the effects of the drug may weaken as your body gets accustomed to it.
The only way to ensure you’re taking hydroxyzine safely is to stick to your doctor’s recommended doses and other instructions. Before your healthcare provider prescribes hydroxyzine for sleep, make sure they’re aware of other conditions you may have or any drugs you’re taking.
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How To Take Hydroxyzine for Insomnia Safely
Most people who take hydroxyzine for sleep disorders ingest it in the form of oral tablets. While the average dose for sleeplessness is 50 mg per day, older patients are often prescribed lower doses because the medication can have a stronger effect on them.
The safest and most effective way to take hydroxyzine for sleeplessness is to follow the instructions of a sleep specialist. Sleep disorders are complex, and their causes vary between cases. It takes an experienced professional to improve your sleep hygiene with the right medication and cognitive-behavioral therapy for insomnia (CBT-I) best practices.
A sleep expert has the knowledge and experience to provide a personalized solution based on your medical history, current lifestyle, and general health—often based on off-label, non-addictive medication like hydroxyzine.
The only issue is that less than 1% of doctors specialize in sleep medicine. Finding a sleep specialist in your area may be difficult, and even if you do, it could be months before you get an appointment. With 33% of working-age adults experiencing chronic insomnia, most sleep doctors have their hands (and calendars) full.
Telemedicine platforms may be a solution. For instance, an online performance medicine clinic like Kick can help you deal with sleep issues immediately from the comfort of your home.
Kick—Science-Based Sleep Solutions
Kick quickly connects you to an experienced sleep specialist—you’ll have your first appointment within 24 hours of signing up.
Based on your first consultation, our doctor will prescribe medication for a trial run—our experts at Kick focus on gentler, less addictive drugs like hydroxyzine. You’ll receive prescriptions for two medications, which you should try according to the doctor’s instructions. The trial runs for two weeks, so you take each medicine for a week.
Our experts will check in regularly and analyze your reaction to the prescribed drugs so they can adjust your medication and doses until you develop a healthy sleep routine. The drugs are also rotated to ensure no dependency. Besides the medication, our sleep doctors will recommend other methods like CBT-I techniques to improve your sleep hygiene.
Prescribed drugs will be shipped to your home or the nearest pharmacy—wherever you decide. Kick saves you precious time and energy while helping you get some much-needed rest.
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How To Get Started With Kick
To start your mornings energized with Kick, follow these simple steps:
- Go to the signup page and start your 15-minute sleep visit
- Enter the required information about your medical history and sleep issues
- Choose whether you want your medication to be mailed to your home or a local pharmacy
After your first consultation, our specialists will determine whether Kick is a suitable solution for you. If not, you’ll be directed to your primary doctor, and you won’t be charged for the consultation—that’s the Kick Doctor Guarantee. Otherwise, your prescription will be filled out, and you’ll receive your first round of medications quickly.
Kick has helped many people overcome sleeplessness and get the necessary rest for productive, high-powered days. You can check our raving Trustpilot reviews to see how many people now sleep easily thanks to our therapy. To start your days the right way, sign up for Kick today and start celebrating your mornings!
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What Are the Side Effects of Hydroxyzine?
The most common side effects of hydroxyzine are:
- Dry mouth
- Lack of focus
- Low blood pressure
Some patients go through severe side effects of hydroxyzine, while others report no adverse reactions at all. Your experience with the medication depends on various factors, such as:
- Interactions with other conditions
- Other medication
- Prescribed doses
Until you’re sure how the medication affects you, avoid driving and other tasks requiring sharp focus. Most side effects lessen or disappear once you’ve adjusted to hydroxyzine, which should take a few days at most. If they don’t, contact your doctor, and they’ll alter your dose or change the medication.
Inform your doctor of any other drugs you’re currently taking when they recommend hydroxyzine therapy, and keep them updated if you start or stop taking any medication in the meantime. Your healthcare provider must be aware of this to help you avoid side effects.
For instance, patients may experience additional dizziness, nausea, and low blood pressure if they take hydroxyzine with antidepressant medications like Zoloft and trazodone or if they have chronic heart conditions.
If you notice an allergic reaction to hydroxyzine, contact your doctor immediately. Minor reactions, like itchy skin and a runny nose, will subside once you switch to another medication. If you experience a more serious allergic reaction, such as having trouble breathing, seek medical assistance immediately.
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Who Can and Can’t Use Hydroxyzine?
While hydroxyzine is one of the milder options among sedatives prescribed for sleep problems, it’s not suitable for everyone. The table below contains information on who can and can’t take this drug:
The FDA classifies drugs based on the risks of fetal defects when taken during pregnancy. Class C means that there haven’t been peer-reviewed studies in humans, but research on animals has confirmed adverse effects—making hydroxyzine potentially unsafe for pregnant women.
The drug is also unsuitable for people with prolonged QT intervals. In such cases, using hydroxyzine could lead to arrhythmia or exacerbate existing heart issues.
Since the liver metabolizes hydroxyzine, people suffering from liver diseases might not process the drug properly. This could result in an accumulation of hydroxyzine in the body, leading to potential adverse effects.
Some studies have shown that first-generation antihistamines like hydroxyzine and Benadryl may be unsafe for patients over 65. Besides the more pronounced dizziness and confusion, the drug is linked to an increased risk of late-onset dementia in the elderly.
Keep in mind that this isn’t an exhaustive list—a sleep specialist can provide more details on who can safely take hydroxyzine, and it’s imperative to heed their advice to avoid adverse effects.
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