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

Most common
Drowsiness (not specified)
Dry mouth (not specified)
Pruritus (not specified)
Rash (not specified)

Hydroxyzine

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

Vistaril vs. Hydroxyzine Dosage

Vistaril

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 50-100 mg At the start
Maximum dose 50 mg If needed
Dose changes 1 increase As tolerated

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

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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