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Cyclobenzaprine and Hydroxyzine—Your Guide to Combining Them Safely

Cyclobenzaprine and Hydroxyzine—Your Guide to Combining Them Safely

It’s 7 a.m. You’re about to get out of bed but feel overwhelmed and drained, and you realize another night without much-needed restorative sleep has passed. These restless nights have begun affecting your productivity at work, prompting you to try herbal teas, counting sheep, and cardio exercises to improve your sleep. Despite your efforts, you’ve only achieved limited success.

If that’s the case, you might consider prescription sleep medications. Among the various options, your doctor may prescribe cyclobenzaprine and hydroxyzine. Despite these drugs’ effectiveness in treating insomnia, they’re not strictly sleep medications, so you might need to combine them if you're treating another condition with one of these. 

So, is it safe to take cyclobenzaprine and hydroxyzine together? We’ll explain their potential interactions and effects as well as how to combine them safely.

Understanding Cyclobenzaprine and Hydroxyzine

Cyclobenzaprine and hydroxyzine have different mechanisms of action, but they have similar effects on the central nervous system (CNS) that can help treat patients with secondary insomnia.

How Cyclobenzaprine Works

Cyclobenzaprine is a skeletal muscle relaxant used to alleviate the symptoms of musculoskeletal problems, such as muscle spasms. Research shows that the drug can improve sleep in the short term, so sleep doctors typically prescribe it to individuals experiencing occasional sleeplessness.

The medication promotes sleep in three steps:

  1. It reduces muscle hyperactivity via the gamma and alpha systems, relaxing your muscles
  2. It blocks pain sensations sent to the brain, alleviating the discomfort caused by muscle pain
  3. Its anticholinergic effects kick in, inducing drowsiness conducive to sleep

Cyclobenzaprine comes in tablet and capsule forms, with five doses available:

  1. 5 mg
  2. 7.5 mg
  3. 10 mg
  4. 15 mg
  5. 30 mg

How To Dose Cyclobenzaprine for Sleep

When taken for sleeplessness, the average daily dose for cyclobenzaprine is 5 mg, administered orally. The drug kicks in within 30–60 minutes of administration, so you should take it at least 30 minutes before bedtime. You should also allocate at least seven hours of sleep for the medication to take full effect and wear off naturally. 

Keep in mind that these are general guidelines, and you should talk to your doctor for a personalized treatment plan to ensure effectiveness.

Learn some basic facts about cyclobenzaprine in the table below:



Key ingredient

Cyclobenzaprine hydrochloride

Drug classification

Muscle relaxant 

Primarily indicated for

Muscle spasms

FDA approval 



Tablet, capsule

Available doses

5 mg, 7.5 mg, 10 mg, 15 mg, 30 mg

Suitable for children

Not approved for patients under 15

Pregnancy category

Category B (no adequate studies on humans)

Treatment duration

3 weeks maximum

Source: Thể Phạm

How Hydroxyzine Works

Hydroxyzine, sold under brand names like Atarax and Vistaril, is a prescription antihistamine used to treat the symptoms of allergies. Still, clinical studies show that the medication is effective in treating sleep issues. It promotes sleep in three ways:

  1. It blocks the action of histamine at the H1 receptors when ingested, reducing activity in the CNS and inducing a calming effect
  2. It boosts serotonin levels in the brain, reducing anxiety
  3. The reduced anxiety and improved relaxation induce drowsiness, making it easier to fall asleep

Hydroxyzine comes in tablet, capsule, and liquid forms, and is available in the following doses:

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

How To Dose Hydroxyzine for Sleep

The average starting dose for adults with insomnia is 50 mg daily, but patients over 65 and individuals with chronic diseases typically take lower doses.

You should take hydroxyzine 30 minutes before bedtime. The drug kicks in within 30–60 minutes and reaches peak concentration in the bloodstream about two hours after you’ve taken it. The effects should subside within 4–6 hours. If you experience daytime drowsiness the following day, you should avoid driving, operating machinery, and doing other tasks that require sharp focus.

In the table below, you’ll find general information about hydroxyzine:



Key ingredient

Hydroxyzine dihydrochloride

Drug classification

Histamine H1 antagonist

Primarily indicated for

Allergic skin reactions like itching and contact dermatitis

FDA approval 



Oral tablet, oral capsule, liquid (oral syrup and intramuscular injection)

Available doses

10 mg, 25 mg, 50 mg

Suitable for children

Yes (for treating other conditions but not for sleeplessness)

Pregnancy category

Category C (risks can’t be ruled out)

Treatment duration

3–4 months maximum

Pregnant and breastfeeding women should approach hydroxyzine and cyclobenzaprine with caution—there’s not enough information to claim that these medications are safe for them.

Can You Take Cyclobenzaprine With Hydroxyzine?

You shouldn’t mix cyclobenzaprine with hydroxyzine without your doctor’s instructions. Combining them may increase their sedative effects or the risk of adverse reactions.

You should consult your healthcare provider for personalized advice on safely combining hydroxyzine and cyclobenzaprine. Additional safety guidelines include:

  • Only take the prescribed dose—If you miss a dose, take it as soon as you remember. If it’s time for your next dose soon, skip the missed one and continue with your regular schedule
  • Stick to the prescribed schedule—Take the medications at the recommended times for their full effect to kick in and subside naturally before you wake up
  • Inform your doctor about your progress—If the medications don’t provide the desired results, talk to your healthcare provider so they can adjust the treatment
  • Inform emergency medical personnel—If you need medical attention for any reason, inform the healthcare professionals that you’re taking hydroxyzine and cyclobenzaprine. This will help them make crucial decisions, including considering potential interactions with the drugs they may prescribe

Source: Alena Shekhovtcova

How Long After Cyclobenzaprine Can I Take Hydroxyzine?

The exact time to wait before taking hydroxyzine after cyclobenzaprine can vary depending on your overall health, metabolism, and other medications you’re taking. Still, cyclobenzaprine has a half-life of 18 hours, so your doctor may recommend taking hydroxyzine 24 hours after it.

If your healthcare provider prescribes both medications for sleep, they’ll likely recommend alternating between them every night. This will reduce the risk of psychological dependence on a single drug and optimize the treatment quickly.

Cyclobenzaprine vs. Hydroxyzine—Which Is Better for Sleep?

When choosing between cyclobenzaprine and hydroxyzine, factors like your medical history, the nature of your sleep problems, and current health status should be considered. These medications can only be used in the short term, so you may need different treatment if your sleep problems persist after treatment discontinuation. 

Sleep issues can result from several complex factors, so you should consult a specialist for the best treatment. With only 1% of physicians specializing in sleep medicine, getting an appointment with a sleep doctor may require a significant wait.

The good news is that Kick, a telemedicine performance clinic, has a fantastic sleep program that connects you with sleep experts almost instantly. Designed by a Stanford sleep expert, Dr. Alex Dimitriu, our program has helped many patients achieve better sleep, as evidenced by consistently high ratings on Trustpilot.

Source: SHVETS production

Kick—Sleep Confidently

Kick offers a convenient solution to sleeplessness, allowing you to skip time-consuming doctor visits. Our sleep program combines cognitive behavioral therapy for insomnia (CBT-I) best practices and gentle sleep medications, such as:

  • Cyclobenzaprine
  • Hydroxyzine
  • Trazodone
  • Gabapentin
  • Ramelteon
  • Doxepin

When you join the program, our expert will thoughtfully select two medications based on your case. Your doctor will also schedule routine online consultations and adjust the treatment if you’re experiencing sleepless nights after starting your treatment and avoid the risk of dependence on one drug.

Your designated specialist will offer tips on healthy sleep hygiene to help you achieve restorative sleep quickly.

How To Join Kick

To begin your journey with Kick, follow three simple steps:

  1. Visit our signup page to start your 15-minute consultation
  2. Fill out the form to help us understand your sleep issues and medical history
  3. Provide your shipping details—you can choose between local pharmacy or home delivery, guaranteeing discretion

Our doctor will review your information within 24 hours and prescribe two trial medications to help you get the most effective treatment quickly. If our team decides Kick isn’t the best solution in your case, we won’t charge you for the initial consultation, according to our Doctor Guarantee.

Source: Los Muertos Crew

Cyclobenzaprine and Hydroxyzine Side Effects

Cyclobenzaprine and hydroxyzine carry the risk of side effects. Patients who follow their doctor’s guidelines rarely experience them, but you should watch out for them to ensure safe and effective use of these medications.

Common Side Effects of Cyclobenzaprine

The common side effects of cyclobenzaprine include:

  • Dry mouth
  • Constipation 
  • Fatigue
  • Stomach upset
  • Drowsiness
  • Dizziness
  • Headache

Common Side Effects of Hydroxyzine

The common side effects of hydroxyzine include:

  • Dry mouth
  • Dizziness
  • Constipation
  • Confusion

Adverse Reactions to Cyclobenzaprine and Hydroxyzine

Both medications have similar severe side effects. Patients who experience the following symptoms after taking these drugs should contact their doctors immediately:

  • Irregular heartbeat
  • Fever
  • Seizure
  • Prolonged nausea
  • Restlessness
  • Severe drowsiness

Keep in mind that the above lists aren’t exhaustive. You should contact your doctor if you experience unexplained physical or cognitive changes.

Cyclobenzaprine and Hydroxyzine—Potential Interactions With Other Medications

Check out the potential interactions between hydroxyzine and cyclobenzaprine with other medications in the table below:


Interaction With Hydroxyzine

Interaction With Cyclobenzaprine

Opioids and CNS depressants (e.g., tramadol)

Can contribute to the CNS depressant effects 

Can add to the sedative effects

Heart medications

Consult your doctor for personalized advice

Talk to your doctor for personalized risk assessment

Blood pressure medication

Consult your healthcare provider for specific advice

Can contribute to the risk of increased heartbeat

Anti-seizure medication (e.g., gabapentin)

Can raise the risk of seizure

Can enhance the risk of seizure

Anti-HIV drugs

The potential for interaction is low but can’t be ruled out

There are no known significant interactions, but the possibility can’t be ruled out

Infection medication

Can raise the risk of abnormal heart rhythm

Not enough information to suggest there’s interaction, but it can’t be ruled out

Sleep or anxiety medications (e.g., Xanax, Valium, Ativan, Zoloft, and Doxylamine)

Can enhance the sedative effects

Can enhance the risk of severe drowsiness

Muscle relaxants (e.g., baclofen)

Can enhance the risk of side effects

Can cause additive effects

Antihistamines (e.g., Benadryl)

Can raise the risk of severe drowsiness

Can raise the risk of side effects

Dietary supplements (e.g., melatonin)

Can enhance the risk of drowsiness, difficulty concentrating, and poor judgment

Can enhance the sedative effects

Non-steroidal anti-inflammatory drugs (e.g., ibuprofen)

Not enough information to suggest there’s interaction, but the risks can’t be ruled out

The potential for interaction is low but can’t be ruled out

This list isn’t exhaustive, so you should consult your doctor for more information on possible interactions.

Cyclobenzaprine and Hydroxyzine—Potential Interactions With Food, Alcohol, and Marijuana

Cyclobenzaprine and hydroxyzine may interact with food, alcohol, and marijuana, so check out the table below for more details:


Interaction With Hydroxyzine

Interaction With Cyclobenzaprine

Grapefruit juice

Can raise the risk of QT prolongation

Can raise the risk of overdose


Can raise the risk of side effects

Can raise the risk of poor coordination and fainting


Can contribute to dizziness

Can enhance the sedative effects

Keep in mind that individual responses to these drugs can vary. Before taking cyclobenzaprine and hydroxyzine, inform your healthcare provider about all medications or substances you’ve been using.

Featured image source: Miriam Alonso