Vistaril vs. Hydroxyzine
See how Vistaril and Hydroxyzine compare on approved uses, dosing, side effects, and cost.
Key Takeaways
Vistaril and hydroxyzine are two different salts of the same active ingredient, hydroxyzine, so they treat anxiety and allergic itching in largely the same way.
Vistaril comes as a capsule or oral suspension, while hydroxyzine HCl comes as a tablet or oral solution, so the form you can swallow may guide the choice.
Hydroxyzine's newer generic label lists specific side effect rates like drowsiness up to 28 percent, while Vistaril's older label only names the reactions without exact percentages.
Vistaril vs. Hydroxyzine Drug Summary
Vistaril
Vistaril is the brand name for hydroxyzine pamoate, an antihistamine used to treat anxiety and tension, itching from allergic skin conditions, and to provide sedation before and after anesthesia. It is taken as an oral capsule or oral suspension, usually several times a day.
Hydroxyzine
Hydroxyzine hydrochloride is the same type of antihistamine, used to treat anxiety and tension, itching from allergic skin conditions, and sedation before and after anesthesia. It is taken as an oral tablet or oral solution, usually up to four times a day.
Vistaril vs. Hydroxyzine Side Effects
Vistaril
Hydroxyzine
Vistaril vs. Hydroxyzine Dosage
Vistaril
Hydroxyzine
| STAGE | DOSE | WHEN |
| Starting dose | 50-100 mg | At the start |
| Maximum dose | 50 mg | If needed |
| Dose changes | 1 increase | As tolerated |
| STAGE | DOSE | WHEN |
| Starting dose | 50-100 mg | At the start |
| Maximum dose | 50-100 mg | Same as starting |
| Dose changes | None | Fixed dose |
Vistaril
| STAGE | DOSE | WHEN |
| Starting dose | 50-100 mg | At the start |
| Maximum dose | 50 mg | 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 |
Vistaril vs. Hydroxyzine Indications
Vistaril
Vistaril is FDA-approved for short-term relief of anxiety and tension linked to psychoneurosis, as an add-on when anxiety accompanies another medical condition, and for itching from allergic skin conditions. It is also used for sedation before and after general anesthesia.
Anxiety and tension associated with psychoneurosis
Adjunct treatment for anxiety in other conditions
Itching from chronic hives or allergic dermatitis
Sedation before and after general anesthesia
Hydroxyzine
Hydroxyzine HCl is FDA-approved to relieve anxiety and tension, control itching from allergic skin conditions, and provide sedation before and after general anesthesia. It is used the same way in both adults and children, with dosing adjusted by age.
Anxiety and tension in adults and children
Adjunct treatment for anxiety in other conditions
Itching due to allergic skin conditions
Sedation before and after general anesthesia
Vistaril vs. Hydroxyzine Pros and Cons
Vistaril
Vistaril has been used clinically since the 1950s and comes as both a capsule and a liquid oral suspension, which helps patients who cannot swallow pills. Its FDA label names the reactions it can cause but does not report exact frequency percentages.
Pros
Available as oral suspension for those who can't swallow capsules
Long track record in clinical use dating back to the 1950s
No boxed warning on its FDA label
Cons
FDA label doesn't list specific side effect percentages
Requires dosing multiple times a day, same as hydroxyzine HCl
Fewer generic manufacturer options than hydroxyzine HCl
Hydroxyzine
Hydroxyzine HCl carries newer generic labeling that lists specific side effect rates, giving a clearer sense of how often drowsiness, dry mouth, or other reactions occur. It is only available as a tablet or oral solution, since brand versions have been discontinued.
Pros
FDA label lists specific side effect rates for easier comparison
Available as tablet or oral solution from many generic makers
Widely stocked as a common, decades-old generic
Cons
No capsule form available, only tablet or solution
No longer sold under a brand name, generic only
Reported rates of weight gain and concentration trouble in trials
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