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Rx Antihistamines · First-generation H1 antihistamine

Hydroxyzine (Atarax / Vistaril): Prescription Antihistamine for Severe Itch + Sleep

Brand names: Atarax, Vistaril

Last reviewed June 9, 2026 · Medically reviewed by AllergyCenter

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For prescription strengths, combination products, or higher doses.

  • Hydroxyzine HCl (Atarax) or hydroxyzine pamoate (Vistaril)
  • For severe chronic hives — pair with daytime non-sedating antihistamines
  • Short-term use for flares or longer-term use under provider guidance
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Hydroxyzine is a strong, fast-acting prescription antihistamine. Allergists commonly use it for severe itching, chronic hives that don't respond to OTC antihistamines, and sleep issues caused by allergy or anxiety symptoms.

Because it's a first-generation antihistamine, hydroxyzine causes significant drowsiness — which is part of why it works so well at night. Most patients take it at bedtime or use it short-term for symptom flares.

Quick Facts

Generic name
Hydroxyzine hydrochloride (Atarax) or hydroxyzine pamoate (Vistaril)
Brand names
Atarax, Vistaril
Drug class
First-generation H1 antihistamine (sedating)
Form
Tablet, capsule, syrup
OTC or Rx
Prescription only
Typical adult dose
25–100 mg every 6–8 hours as needed
Age range
6 months+ (dose by age)
Onset of action
15–30 minutes; effects last 4–6 hours
Sedation
Significant. Do not drive after taking; usually taken at bedtime or for short-term symptom control.

TL;DR — At a Glance

  • ·Hydroxyzine (Atarax, Vistaril) is a prescription sedating antihistamine.
  • ·Used for severe itch, chronic hives, allergy-related anxiety, and sleep issues.
  • ·Typical adult dose: 25–100 mg every 6–8 hours as needed.
  • ·Causes significant drowsiness — do not drive after taking.
  • ·Common side effects: drowsiness, dry mouth, blurred vision.

Get a hydroxyzine prescription

For severe itching, stubborn hives, or sleep issues from allergies, an allergist can review your case and prescribe hydroxyzine after a $49 async consult.

Medical Disclaimer: This guide is for educational purposes only and is not a substitute for medical advice, diagnosis, or treatment from a licensed healthcare provider. Do not start, stop, or change any medication without consulting a qualified provider.