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Hydroxyzine vs. Doxylamine—Which Drug Is Better for Sleeplessness?

Hydroxyzine vs. Doxylamine—Which Drug Is Better for Sleeplessness?

Getting enough sleep before an important day at the office can be challenging—the pressure and excitement make it difficult to get some decent shut-eye.

Working-age adults lose over 40% of workplace productivity per year due to sleep disorders. If you’re facing such an issue, you should seek help from sleep experts. They can help you overcome sleeplessness and wake up energized by prescribing effective drugs like hydroxyzine or doxylamine and offering practical advice on improving your sleep hygiene.

Still, seeing a sleep specialist isn’t easy because the experts in the field are scarce, so getting the right treatment might be challenging. To find the best solution for your sleep issues, check out our detailed hydroxyzine vs. doxylamine comparison, which also explains how to connect to top-notch sleep experts effortlessly.

Hydroxyzine and Doxylamine—Basic Information

Doxylamine and hydroxyzine are both antihistamines. They suppress the production of a chemical called histamine, which the body produces when exposed to allergens. By blocking histamine, these drugs mitigate allergic reactions like:

  • Redness
  • Itching
  • Swelling

Doctors sometimes prescribe specific antihistamines, such as hydroxyzine and doxylamine, as an off-label treatment for sleep problems and anxiety because they also have a sedative effect.

Histamine keeps us awake by transmitting information to specific brain receptors, and when the chemical is suppressed, we become sleepy. Hydroxyzine and doxylamine also induce drowsiness by blocking acetylcholine, another brain chemical tied to alertness.

The Food and Drug Administration (FDA) first approved doxylamine in 1948 under the brand name Decapryn, while hydroxyzine received approval in 1956 as Vistaril. Neither of the two are controlled substances since they have no or low potential for misuse and dependence, according to the Drug Enforcement Administration (DEA).

Learn more basic facts about hydroxyzine and doxylamine in the table below:




Active ingredient

Doxylamine succinate

Hydroxyzine hydrochloride

Dosages for sedation

25 mg

25 mg, 50 mg, and 100 mg


Oral tablet 

Oral tablet, syrup, capsule, injection

Generic version



Suitable for children

6 years and older (not for insomnia)

Yes (not for insomnia)

Suitable for pregnant women

Risk not ruled out

Risk not ruled out

Average price



Doxylamine vs. Hydroxyzine for Sleep—Administration and Dosage

It’s crucial to always consult your healthcare provider regarding drug doses. They’ll determine the most appropriate dosage based on your medical history and sleep issues. Over time, they may also change the doses and the prescribed drugs.

The usual hydroxyzine dose for adults with sleep problems is 50 mg per day, administered 30 minutes before bedtime. For doxylamine, the typical dose for insomnia is 25 mg per day, also taken 30 minutes before bed.

Hydroxyzine and doxylamine haven’t been tested for long-term use in cases of insomnia. Clinical tests have proven the positive effects of hydroxyzine on sleeplessness and anxiety when taken for up to four months, while doxylamine shouldn’t be used for more than two consecutive weeks.

When taken orally, both drugs should be swallowed with a glass of water. Until you’re sure how the medications affect you, avoid activities that require sharp focus, like operating machinery or driving.

If doxylamine doesn’t reduce your insomnia in ten days, consult your healthcare provider and see if the dose or the medication needs changing.

Source: Kampus Production

Doxylamine vs Hydroxyzine for Sleep—Which One Is More Effective?

Hydroxyzine and doxylamine are similar options for off-label sleep medication, with comparable administration, contraindications, side effects, and effectiveness. Which one will work for you depends on your particular case.

The best course of action for overcoming sleep problems is to consult an experienced sleep doctor. They’ll examine the underlying causes and severity of your insomnia, consider any obstacles to using different drugs, and recommend how to proceed.

Proper sleep specialists can help by applying cognitive behavioral therapy for insomnia (CBT-I) techniques and combining them with effective drugs like hydroxyzine and doxylamine. Sleep problems are complex, and only a holistic approach designed by an expert can help you resolve the issue in the long run.

Considering less than 1% of doctors specialize in sleep-related treatments, it could be months before you can get an appointment, which is bad news when battling with restless nights.

Still, not all is grim because a platform like Kick can help you connect with a remote sleep expert right away. With a personalized approach that takes into account your medical history, current health, and specific sleep issues, Kick’s specialists can help you improve your sleep quality in no time.

Sleep Better, Feel Better With Kick

Kick will give you access to an experienced sleep medicine specialist almost instantly. Our experts will assess your case and get back to you with an initial treatment plan within a day. They’ll prescribe two drugs and monitor your reactions to each over the next few weeks. Kick’s doctors don’t resort to generic drugs—instead, they tailor the treatment specifically to you, offering off-label but effective prescriptions like hydroxyzine.

Once the treatment starts, your doctor will regularly check in, adjust your medication, and provide practical advice for establishing a healthier sleeping pattern based on CBT-I best practices. Kick’s platform helped many people overcome sleeplessness, as evidenced by our excellent Trustpilot reviews.

To begin improving your sleep with Kick, you only need to: 

  1. Visit the signup page and start your 15-minute sleep visit
  2. Fill out a form to let us better understand your current sleep issues and medical history
  3. Submit your payment details and delivery address

In case our team concludes that our sleep program isn’t the best solution for your problems, you won’t pay for the initial consultations as per our Doctor Guarantee. Otherwise, your first batch of medication will be sent right away. You can have your medication delivered to a local pharmacy or your doorstep.

Source: Tania Mousinho

Doxylamine Succinate vs Hydroxyzine Hydrochloride—Potential Side Effects

Hydroxyzine and doxylamine can have similar side effects. The three most frequent unwanted reactions to the medications are:

  1. Blurred vision
  2. Constipation
  3. Dry mouth

You may suffer from temporarily blurred vision if the drugs impact the dilating muscles in your pupils. Constipation is another common side effect of antihistamines on your gastrointestinal muscles. Both medicines may also reduce saliva production, leading to a dry mouth. 

In rarer cases, doxylamine may trigger more severe vision issues and difficulty urinating. Contact your doctor if these symptoms don’t subside quickly.

The less common side effects of hydroxyzine are:

  • Seizures or shaking movements
  • Rashes 
  • Lesions, blisters, fever, and skin swelling

These adverse effects might point to a severe allergic reaction to hydroxyzine. If you notice them, consult your doctor and seek immediate medical care. 

Source: bruce mars

Hydroxyzine and Doxylamine—Who Should Avoid Them?

Due to the potential for serious side effects, doxylamine is usually not prescribed to the following groups:

  1. Children younger than 4
  2. Adults older than 65

Hydroxyzine is generally safe for children, but not for treating insomnia. It can be unsuitable for older patients, as research has linked long-term use of certain antihistamines with increased risk of dementia in the elderly.

It’s not yet certain whether hydroxyzine and doxylamine can be taken during pregnancy. No study has proven that the drugs cause birth defects, but risks haven’t been ruled out yet. Until more conclusive evidence is available, it’s best to be cautious and avoid both medications if you’re pregnant.

The same goes for breastfed infants. Small, rare doses of doxylamine shouldn’t reduce the milk supply or cause adverse effects in infants. Still, the scope of relevant published sources on the topic is limited to one telephone follow-up study with inconclusive results. 

Long-term research suggests that adverse reactions to hydroxyzine have been reported in breastfed infants whose mothers used the medication, the most common side effect being sedation.

Since risks haven’t been ruled out, mothers who breastfeed should refrain from taking hydroxyzine or doxylamine and consult their doctor for alternatives.

Condition Interactions

Some medical conditions trigger more severe adverse reactions to hydroxyzine and doxylamine. If you suffer from any of them, consult your sleep doctor, who will likely recommend a lower dose or alternative medications. 

The table below outlines the most common interactions between the two drugs and various conditions:

Medical Condition

Interaction With Hydroxyzine and Doxylamine


Treatment of patients with a history of psychological issues, like depression or anxiety, involves a more careful approach to sedation to avoid mood swings 

Breathing difficulties

Antihistamines may cause or exacerbate respiratory tract obstruction in individuals with asthma or other chronic breathing problems 

Cardiovascular problems

Individuals with cardiovascular disease may suffer from arrhythmias, tachycardia, heart palpitations, hypertension, and hypotension

Liver and renal disease

Patients might not metabolize antihistamines properly in their livers or eliminate them through urine, causing accumulation

While hydroxyzine and doxylamine share most condition interactions, hydroxyzine also has a unique one—QT prolongation. Individuals with a high risk of a prolonged QT interval shouldn’t take the medication to avoid the possibility of heart failure.

If you suffer from any conditions on the list or other issues your healthcare provider should be aware of, present them transparently to your sleep doctor so they can decide whether hydroxyzine or doxylamine is an option for you.

Source: Andrea Piacquadio

Substance Interactions

Doxylamine and hydroxyzine interact with various medications, though doxylamine has much fewer interactions—only with 306 other drugs, compared to hydroxyzine’s 571 drug interactions.

Here are some of the medicines you should avoid using with hydroxyzine and doxylamine due to possible interactions:

Consuming alcohol while taking these antihistamines would also be ill-advised—you may experience thinking and judgment impairment, along with general dizziness.

Featured image source: Andrea Piacquadio