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

Most common
Drowsiness (up to 28%)
Dry mouth (up to 14%)
Weight gain (up to 12%)
Trouble concentrating (up to 9%)

Restoril

Most common
Drowsiness (up to 9.1%)
Headache (up to 8.5%)
Fatigue (up to 4.8%)
Nervousness (up to 4.6%)

Hydroxyzine vs. Restoril Dosage

Hydroxyzine

Dosage
Dosage Table
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

Dosage
Dosage Table
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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