Hydroxyzine vs. Restoril
See how Hydroxyzine and Restoril compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Restoril is FDA-approved for short-term insomnia, while using hydroxyzine for sleep is an off-label choice based on its sedating side effect.
Hydroxyzine is not a controlled substance, but Restoril is a Schedule IV benzodiazepine with boxed warnings for abuse and dependence.
Both drugs commonly cause next-day drowsiness, so avoid driving or operating machinery until you know how the medication affects you.
Hydroxyzine vs. Restoril Drug Summary
Hydroxyzine
Hydroxyzine is a first-generation antihistamine FDA-approved to treat anxiety and itching from allergic skin conditions, and as a sedative before or after surgery. Its strong sedative effect leads some doctors to prescribe it off-label for short-term sleep trouble. It's usually taken as a tablet, capsule, or liquid, dosed several times a day.
Restoril
Restoril (temazepam) is a benzodiazepine hypnotic FDA-approved for short-term treatment of insomnia, generally limited to 7 to 10 nights of use. It's taken as a single capsule at bedtime, with doses starting at 7.5 mg and increasing up to 30 mg based on response. As a Schedule IV controlled substance, it carries boxed warnings for abuse, dependence, and dangerous opioid interactions.
Hydroxyzine vs. Restoril Side Effects
Hydroxyzine
Restoril
Hydroxyzine vs. Restoril Dosage
Hydroxyzine
Restoril
| STAGE | DOSE | WHEN |
| Starting dose | 50-100 mg | At the start |
| Maximum dose | 50-100 mg | Same as starting |
| Dose changes | None | Fixed dose |
| STAGE | DOSE | WHEN |
| Starting dose | 7.5 mg | At the start |
| Maximum dose | 30 mg | If needed |
| Dose changes | 3 increases | As tolerated |
Hydroxyzine
| STAGE | DOSE | WHEN |
| Starting dose | 50-100 mg | At the start |
| Maximum dose | 50-100 mg | Same as starting |
| Dose changes | None | Fixed dose |
Restoril
| STAGE | DOSE | WHEN |
| Starting dose | 7.5 mg | At the start |
| Maximum dose | 30 mg | If needed |
| Dose changes | 3 increases | As tolerated |
Hydroxyzine vs. Restoril Indications
Hydroxyzine
Hydroxyzine's FDA-approved uses are short-term relief of anxiety and tension, and itching from allergic skin conditions like hives or eczema. It's also approved as a sedative before and after surgery. Taking it specifically to fall asleep is off-label, though many clinicians prescribe it this way because of its sedative effect.
FDA-approved for anxiety and tension symptoms
FDA-approved for itching from allergic skin conditions
FDA-approved as a pre- and post-surgery sedative
Often used off-label for short-term sleep trouble
Restoril
Restoril is FDA-approved only for the short-term treatment of insomnia, generally no more than 7 to 10 nights. It is not approved for anxiety disorders or for longer-term, routine use. As a benzodiazepine, it slows brain activity to help you fall asleep faster.
FDA-approved specifically for short-term insomnia
Recommended for only 7 to 10 nights of use
Not approved for anxiety disorders
Schedule IV controlled substance due to misuse risk
Hydroxyzine vs. Restoril Pros and Cons
Hydroxyzine
Hydroxyzine isn't a controlled substance, so it avoids the dependence and overdose warnings tied to benzodiazepines. It's generally well tolerated, though its off-label status for sleep and anticholinergic side effects are worth weighing before choosing it for insomnia.
Pros
Not a controlled substance, so no abuse-potential scheduling
No boxed warning for fatal interactions with opioids
Generic version costs roughly $10 to $40 per month without insurance, before discounts
Cons
Not FDA-approved for insomnia, so using it for sleep is off-label
Anticholinergic side effects like dry mouth and weight gain are common
Standard dosing calls for multiple doses a day, less simple than one bedtime dose
Restoril
Restoril has FDA backing specifically for insomnia, with dosing built around a single nightly capsule. That approval comes with a boxed warning for abuse, dependence, and dangerous opioid interactions, plus a much higher price than many alternatives.
Pros
FDA-approved specifically for insomnia, with dosing studied for that purpose
Simple once-daily bedtime dosing
Effective for short-term sleep-onset and sleep-maintenance problems
Cons
Carries a boxed warning for abuse, misuse, and addiction that can lead to overdose or death
Boxed warning for dangerous opioid interactions, including fatal respiratory depression
Risk of physical dependence and withdrawal, including seizures, if stopped abruptly
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