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Hydroxyzine vs. Ambien—Which One To Take for Sleep?

Hydroxyzine vs. Ambien—Which One To Take for Sleep?

If you’re among the 50–70 million adults in the U.S. grappling with sleep issues, the best course of action is to consult your healthcare provider for tips on cultivating healthy sleep habits and a prescription for highly effective sleep medications like hydroxyzine or Ambien.

To give you a better understanding of how these drugs work, this comprehensive hydroxyzine vs. Ambien comparison will explain their mechanisms of action, efficacy for sleep, and potential side effects.

How Does Hydroxyzine Work?

Hydroxyzine is an FDA-approved medication for treating the symptoms of allergic reactions, such as:

  • Itching
  • Hives 
  • Runny nose 
  • Watery eyes
  • Contact dermatitis 

The active ingredient in hydroxyzine is hydroxyzine dihydrochloride, which is classified as an antihistamine. The drug works by suppressing the release of histamine, a neurotransmitter that triggers the body’s response to allergens. 

Thanks to its sedative properties, doctors prescribe this medication to patients with anxiety and insomnia. The drug increases serotonin levels in the brain and slows down the central nervous system, inducing relaxation and promoting sleep.

Check out the available doses in the table below:


Available Doses


  • 10 mg

Tablet (typically used to treat insomnia)

  • 10 mg

  • 25 mg

  • 50 mg


  • 25 mg

  • 50 mg

  • 100 mg

Intramuscular injection

  • 25 mg

  • 50 mg

The standard dose for adults with insomnia is 50 mg in tablet form, taken at least 60 minutes before going to bed. The drug should start to kick in within 30 minutes, but food may delay the onset by 1–2 hours. The effects last 4–6 hours, so you should set aside at least seven hours for sleep for the drowsiness to wear off naturally.

You should also take only the prescribed dose and avoid alcohol while on hydroxyzine to reduce the risk of side effects and tolerance.

Who Can Take Hydroxyzine?

Hydroxyzine can be prescribed to adults experiencing occasional sleeplessness caused by tension, anxiety, allergies, or other conditions if a medical professional deems it necessary.

You can only get it with a prescription from your healthcare provider. Check out the following table for more details on who can and can’t take hydroxyzine:

Who Should Use Hydroxyzine?

Who Shouldn’t Use Hydroxyzine?

  • Adults over 18

  • Patients with occasional sleeplessness

  • Individuals with tension or anxiety

  • People with symptoms of allergic reactions

  • Children (not for insomnia; they can take it for other conditions)

  • Individuals allergic to hydroxyzine or any of its components

  • Patients with heart, liver, kidney, or respiratory diseases

  • Individuals with bladder or urination problems

  • People with long QT syndrome

  • Pregnant or breastfeeding women

  • Individuals taking medications that may interact with hydroxyzine

  • Patients who recently took MAO inhibitors

The Side Effects of Hydroxyzine

Hydroxyzine carries the risk of undesired reactions, which may include:

Patients who experience side effects should consult their doctors.

Source: DieterRobbins

How Does Ambien Work?

Ambien is the most popular Z-drug, with over 10 million prescriptions written annually. The FDA approved this medicine for treating insomnia in 1992.

The active ingredient in Ambien is zolpidem tartrate, which falls under the category of sedative-hypnotics. Zolpidem tartrate raises the levels of gamma-aminobutyric acid (GABA) in the brain—GABA neurotransmitters slow down brain activity, heart rate, and breathing. This combined effect helps you relax, promoting sleep.

Ambien is available in two variants:

  1. Ambien—Regular tablets
  2. Ambien CR—Extended-release tablets

Ambien CR comes in two layers—the first dissolves immediately, while the second has a delayed onset, making Ambien CR more effective for treating sleep onset and sleep maintenance insomnia.

The drug is available in the following doses:


Available Doses


  • 5 mg

  • 10 mg

Ambien CR

  • 6.25 mg

  • 12.5 mg

The average dosing depends on several factors, including your gender, lifestyle, and health history. Male patients typically start with 10 mg daily, while female patients begin with 5 mg since Ambien is metabolized slower in women than in men.

You should take Ambien one hour before going to bed. Food delays the onset of effects, so you shouldn’t take this drug with or immediately after a meal.

Who Can Take Ambien?

Ambien is typically prescribed to adults with sleep onset or sleep maintenance insomnia. This medication is only available with your doctor’s prescription and is a controlled substance, according to the Drug Enforcement Administration’s schedules of controlled substances.

Here’s a general list of those who should or shouldn’t use Ambien:

Who Should Use Ambien?

Who Shouldn’t Use Ambien?

  • Adults over 18

  • Patients with insomnia

  • Patients with a history of alcohol abuse

  • People with a history of drug dependence

  • Patients with renal, liver, or respiratory disease

  • Individuals with glaucoma

  • Patients suffering from depression

The lists above aren’t exhaustive. Before taking hydroxyzine or Ambien, you should tell your doctor if you have any chronic health conditions or you’ve recently had an emergency medical procedure.

The Side Effects of Ambien

Common side effects of Ambien can include:

  • Dizziness
  • Hallucinations
  • Respiratory distress
  • Next-day drowsiness
  • Sleep-walking
  • Unusual thoughts

Patients who are allergic to Ambien or its components may experience other unwanted reactions like hives, itching, and swelling. You should inform your healthcare provider if you notice any physical or cognitive changes while using this drug.

Avoid activities that require sharp focus—such as driving or operating heavy machinery—while on this medication.

Hydroxyzine vs. Ambien—Which Is More Effective for Sleep?

The most effective medication for insomnia depends on your lifestyle, medical history, and specific sleep issues. While hydroxyzine is gentle and generally effective for the short-term treatment of sleeplessness due to anxiety and tension, Ambien is stronger and typically prescribed for more severe cases of insomnia.

Sleep problems can stem from numerous underlying issues, so these medications alone may not offer a lasting solution. You should visit a sleep specialist to get the best treatment. However, with only 1% of physicians trained in sleep medicine, that may not be easy.

The good news is that telemedicine platforms like Kick offer quick, effective, and comprehensive solutions without complicated procedures.

Source: Vlada Karpovich

Kick—Better Sleep, Better You

Designed by Dr. Alex Dimitriu, a Stanford sleep expert, Kick’s program has earned many raving reviews on Trustpilot—a testament to our expertise and commitment.

Our program doesn’t take a one-size-fits-all approach. When you join Kick, our specialist will design a plan tailored to your health status and specific sleep issues. You’ll get:

How To Join Kick

To join Kick, follow three simple steps:

  1. Go to our signup page to begin your brief sleep visit
  2. Fill out the questionnaire to help us understand your medical history and sleep issues
  3. Provide your shipping and payment details

You can conveniently choose between local pharmacy pickup or home delivery. If our specialist decides you’re the right candidate for the program, they’ll prescribe two trial medications to rotate during the first two weeks and optimize the treatment quickly. Our sleep medications include:

  1. Trazodone
  2. Hydroxyzine
  3. Cyclobenzaprine
  4. Doxepin
  5. Ramelteon
  6. Gabapentin

If necessary, your doctor will adjust the treatment to ensure it’s effective for your case. If our team decides we don’t have the best solution for your specific sleep issue, you won’t pay for the initial consultation as per our Doctor Guarantee.

Source: manbob86

Ambien vs. Hydroxyzine—Hard Facts

Check out the basic similarities and differences between hydroxyzine and Ambien in the table below:




FDA approval



Key ingredient

Hydroxyzine dihydrochloride

Zolpidem tartrate

Drug class






Primarily indicated for

Symptoms of allergic reactions, anxiety, tension



Tablet, capsule, liquid


Available doses

  • 10 mg

  • 25 mg

  • 50 mg

  • 100 mg

  • 5 mg and 10 mg (Ambien)

  • 6.25 mg and 12.5 mg (Ambien CR)

Controlled substance



Potential for physical addiction

Low (psychological dependence can’t be disregarded)


Pregnancy risks

C (risks can’t be ruled out)

C (risks can’t be ruled out)

Treatment duration

3–4 months

7–10 days

Hydroxyzine and Ambien—Potential Interactions With Food, Substances, and Other Drugs

Check out the potential interactions between hydroxyzine and Ambien with food and other drugs in the table below:


Interaction With Hydroxyzine

Interaction With Ambien

Anti-seizure medication

Can enhance the risk of seizure

Consult your healthcare provider

Anti-HIV medication

Can raise the risk of QT prolongation

Consult your doctor for specific guidance


Can contribute to drowsiness

Can enhance the risk of unwanted reactions

Blood pressure medication

Talk to your doctor for personalized advice

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

Dietary supplements  (e.g., melatonin)

Can raise the risk of drowsiness

Can enhance drowsiness

Heart medications

Consult your healthcare provider for a personalized assessment

No interactions were found, but risks can’t be disregarded

Infection medications

Can enhance the risk of abnormal heart rhythm

Consult your healthcare provider for personalized advice

Muscle relaxants (e.g., baclofen)

Can contribute to unwanted reactions

Can contribute to the sedative effects

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

The potential for interaction is low, but risks can’t be disregarded

No interactions were found, but risks can’t be ruled out

Opioids and CNS depressants

Can contribute to the CNS depressant effects

Can enhance the CNS depressant effects

Sleep or anxiety medications

Can enhance the sedative effects

Can contribute to the risk of drowsiness

Grapefruit juice

Can raise the risk of hydroxyzine overdose

Can enhance Ambien’s sedative effects


Can reduce hydroxyzine’s effectiveness for sleep

Can reduce the sedative effects of Ambien


Can enhance drowsiness

Can contribute to drowsiness

This list above isn’t exhaustive—you should inform your healthcare provider about all substances or medications you take before using these sleep medicines.

Hydroxyzine and Ambien Alternatives

Source: Claudio_Scott

Before prescribing hydroxyzine or Ambien, your healthcare provider will assess your sleep issues and health history. If your doctor determines that you’re not the best candidate for either drug, they may suggest other sleep medications, including:

No matter which of these medications works best for you, you should always stick to your doctor’s instructions and take a holistic approach to your sleep issues for the best results.

Featured image source: Alena Shekhovtcova