Getting restless is fine once in a while. But, some 35 million people living in the US tend to worry a lot. In order to treat frequent spells of anxieties, drugs such as hydroxyzine, Xanax, etc. are commonly prescribed. These two drugs do have the needful clearance and approval from the food and drug administration (FDA); but, they belong to two different genres. Of these two, hydroxyzine is an antihistamine drug and hence is used for treating skin conditions such as itching. However, both these drugs are used for treating generalized anxiety disorders (GAD). But, can you take these two meds together, and what are the likely risks of interactions?

Xanax belongs to a class of meds known as benzodiazepines and is used for treating panic disorders. It is also used for calming your mind from anxieties as well as nervousness. Its use is largely restricted to the short term. On the other hand, hydroxyzine is an antihistamine used for itchiness or other skin related allergies. As an extension, hydroxyzine is also used to decrease anxieties, nervous episodes as well as restlessness among users. This drug also finds its use as a sedative which is administered before surgeries and other interventional procedures.

Risks of interactions upon taking hydroxyzine and Xanax together
During extremely intense spells of anxieties, your treating physician may however recommend smaller doses of these two drugs – i.e., hydroxyzine and Xanax. However, it is highly recommended to stop the medication plan once your doctor tells you to discontinue it. Continued intake of either of these drugs can be habit forming, and hence can be addictive. You may also experience daytime sleepiness as well as blurring of eyesight. These side effects are experienced as the antihistamine may start working overtime and may exert its actions with each dose.


Without clinical supervision, such a combination is considered as extremely unsafe. It can lead to near-fatal outcomes; in some cases, it has also led to deaths. You may find it difficult to breathe and may soon pass out or faint. Hydroxyzine is known to boost the effects of Xanax; as a result, you may turn very sleepy, experience acute spells of drowsiness and dizziness. You are advised not to drive, work with heavy machinery or perform sporting activities such as cycling or swimming.

You also need to know that hydroxyzine is an antihistamine while Xanax is a benzodiazepine. Both these drugs – when taken as a sole med – can cause dehydration, excessive levels of drowsiness as well as dizziness. The good thing about hydroxyzine is this med is not habit forming or additive; the same cannot be told of Xanax which is a controlled substance in most countries.

Precautions you need to stay aware of

Initial dosages of hydroxyzine are maintained at 25 mg – 50 mg; the daily dose is thrice or four times. But, the active ingredients start functioning immediately – as soon as 20 minutes from the time of consuming it. So, if you are already taking any opioid meds or sleeping pills (and also, muscle relaxants), your treating doctor needs to be made aware of such drugs. Not reporting about the intake of such pills can worsen the dizziness levels. In most cases, patients have either slipped into a very deep sleep or have passed out.

In treating anxieties, studies do indicate that there are not any major differences in the efficacy of these two drugs. However, Xanax is prescribed in dosage strengths of upto 0.5 mg (and not more). The typical dose of this drug is administered twice or thrice within a 24-hour timeline. Like hydroxyzine, Xanax also works within a shorter span of time; it may take between 45 minutes to an hour for the key chemicals to start working.

Like those taking hydroxyzine, users of xanax must stay away from alcohol, other forms of intoxicants, opioid-based drugs, cough and cold meds, sleeping tablets, pain relieving drugs as well as other anxiety reducing meds. In general, any drug or supplement that may cause dizziness / drowsiness must never be combined with xanax.

A few more safety measures

Users of any of these two drugs who have a low level of potassium or salts such as magnesium must tell their treating physician of such electrolyte imbalances. People who are aged above 50 years or more must talk to their caregiving team if they have had prior allergies or hypersensitivity to antihistamines as well as anxiety decreasing meds. As dizziness is a common discomfort experienced with either of these drugs, it is highly recommended to change postures in a steady fashion – i.e., from a sitting position to a standing / erect posture. You are also advised to be wary of accidental falls; such instances can cause factures or loss of bones among elders as well as in people living with bone conditions such as osteoporosis.

In general, make your caregiving team and pharmacist aware of all your prior medical conditions, treatment plans including meds you currently consume. Users who have a prolonged QT cycles must take added precautions. If you are observing side effects such as chest pain, rapid heartbeats or erratic pulse rates, passing out, etc., you need to rush to a healthcare setting immediately. Those living in the US can contact 911 for faster clinical support; you may also reach out to the helpdesk of the food and drug administration. The FDA runs its own helplines to gather information on side effects drugs it clears cause, and also to provide needful clinical assistance to callers. Those who are living in a Canadian province can call Health Canada or quickly go to a poison control unit.

In sum, intake of hydroxyzine and Xanax is not recommended without proper clinical guidance and medical supervision. Upon taking these drugs in excessive doses you may witness near-fatal or fatal outcomes. Moreover, hydroxyzine may boost the efficacy of Xanax. So, you may witness acute spells of sleepiness, feeling excessively dizzy and also drowsy. It is unsafe to work with heavy machines, drive or engage in adventurous sports like swimming, jumping or cycling. In order to know more on the safety precautions and dosage levels, you are advised to consult with a qualified medical practitioner.

Leave a Reply