Hydroxyzine vs. Serax
See how Hydroxyzine and Serax compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Hydroxyzine is a non-addictive antihistamine used short-term for anxiety and itching, while Serax is a benzodiazepine with a boxed warning for dependence and misuse.
Both drugs commonly cause drowsiness, but hydroxyzine is also linked to dry mouth and weight gain, while Serax carries the added risks of its benzodiazepine class.
Serax is FDA-approved for alcohol withdrawal, a use hydroxyzine does not have, but hydroxyzine typically costs less per month without insurance.
Hydroxyzine vs. Serax Drug Summary
Hydroxyzine
Hydroxyzine is a first-generation antihistamine used for short-term relief of anxiety and tension, as well as itching from allergic skin conditions. It is taken by mouth, usually four times a day, and is not a controlled substance.
Serax
Serax (oxazepam) is a benzodiazepine used to manage anxiety disorders and ease symptoms of alcohol withdrawal. It is taken by mouth several times a day and, as a controlled substance, carries boxed warnings for dependence and misuse.
Hydroxyzine vs. Serax Side Effects
Hydroxyzine
Serax
Hydroxyzine vs. Serax Dosage
Hydroxyzine
Serax
| 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 | 10-15 mg 3-4x daily | At the start |
| Maximum dose | 15-30 mg 3-4x daily | If needed |
| Dose changes | 1 increase | 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 |
Serax
| STAGE | DOSE | WHEN |
| Starting dose | 10-15 mg 3-4x daily | At the start |
| Maximum dose | 15-30 mg 3-4x daily | If needed |
| Dose changes | 1 increase | As tolerated |
Hydroxyzine vs. Serax Indications
Hydroxyzine
Hydroxyzine treats short-term anxiety and tension linked to psychoneurosis, and it relieves itching from allergic skin conditions like hives and eczema. It is also used as a sedative before and after surgery. Some clinicians use it off-label for insomnia, though this is not an FDA-approved use.
Short-term anxiety and tension in psychoneurosis
Itching from allergic skin conditions like hives
Sedation before and after surgery
Off-label: sometimes used for insomnia
Serax
Serax treats anxiety disorders and the short-term symptoms of anxiety, and it is FDA-approved to ease symptoms of alcohol withdrawal. Some clinicians use it off-label for insomnia, though this is not an FDA-approved use.
Management of anxiety disorders
Short-term relief of anxiety symptoms
Relief of alcohol withdrawal symptoms
Off-label: sometimes used for insomnia
Hydroxyzine vs. Serax Pros and Cons
Hydroxyzine
Hydroxyzine is not a controlled substance and carries no known risk of physical dependence, which sets it apart from benzodiazepine options. It also treats itching, giving it a use beyond anxiety alone. It generally costs less out of pocket than Serax.
Pros
Not a controlled substance, no known abuse risk
Also treats itching from allergic skin conditions
Onset of action within 15 to 30 minutes
Lower cost, roughly $15 to $40 per month generic
Cons
Strong anticholinergic effects like dry mouth
Not FDA-approved for alcohol withdrawal
Not established for use beyond 4 months
Serax
Serax is a benzodiazepine with a short half-life and no active metabolites, which can make it easier to dose in older adults or those with liver problems. It carries FDA boxed warnings for abuse, dependence, and dangerous opioid interactions. It typically costs more than non-controlled alternatives like hydroxyzine.
Pros
FDA-approved for alcohol withdrawal too
Short half-life with no active metabolites
Often preferred in elderly or liver disease
Less anticholinergic burden than antihistamines
Cons
Schedule IV controlled substance, abuse risk
Boxed warnings for dependence and opioid risk
Costs roughly $90 to $145 per month
Common Symptoms and Related Diseases You Can Explore
Explore a range of common symptoms the Doctronic Symptom Checker can help you understand.