Can you take hydroxyzine and tylenol at the same time

Hydroxyzine HCl Interactions with Other Medication

Severe Interactions

These medications are not usually taken together. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

Sorry, we have no data available. Please contact your doctor or pharmacist.

Serious Interactions

These medications may interact and cause very harmful effects. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

  • Moderate Interactions

    These medications may cause some risk when taken together. Consult your healthcare professional (e.g., doctor or pharmacist) for more in formation.

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    Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

    CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.

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    Table of Contents

    • Overview
    • How to Take It
    • Side Effects
    • Warnings & Precautions
    • Drug Interactions
    • Dosage & Missing a Dose
    • Storage
    • Pregnancy or Nursing
    • More Information


    Vistaril (hydroxyzine) is an antihistamine that decreases certain symptoms, including hives on the skin, sneezing, and runny nose. It reduces the natural chemical histamine in the body. It is also used to control nausea and vomiting, treat allergic skin reactions such as dermatitis or hives, as a sedative to treat anxiety and tension, and in combination with other drugs for anesthesia.

    It works by reducing activity in the central nervous system.

    This information is for educational purposes only. Not every known side effect, adverse effect, or drug interaction is in this database. If you have questions about your medicines, talk to your health care provider.

    How to Take It

    Follow the directions for using this medicine provided by your doctor. This medicine may be taken on an empty stomach or with food. Continue to take this medicine even if you feel well. Do not miss any doses.

    Side Effects

    Side effects that may occur while taking this medicine include:

    • headache
    • dry mouth
    • hives
    • drowsiness
    • purple or red lesions on the skin

    Contact your doctor immediately if you experience:

    • uncontrolled muscle movements in tongue, jaw or neck
    • hallucinations
    • tremors
    • respiratory issues
    • convulsions

    Warnings & Precautions

    • Vistaril may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
    • Drinking alcohol while taking this medication may cause dizziness, confusion and drowsiness. Avoid alcoholic beverages while taking Vistaril.
    • Interactions can occur if you are taking barbituates, opioids, anticholinergic drugs, aspirin, acetaminophen, and ibuprofen, or any other medications that cause drowsiness. Talk to your doctor about any medications you are currently taking.
    • DO NOT take more of this drug than is prescribed. Overdose most often results in excessive sedation, but it can also cause nausea, convulsions, stupor, and vomiting.
    • Talk to your doctor if you have seizure disorder, liver disease, or kidney disease before taking this medication.
    • DO NOT use this medication if you are allergic to hydroxyzine, or if you are pregnant.
    • For an overdose, seek medical attention immediately. For non-emergencies, contact your local or regional poison control center at 1-800-222-1222.

    Drug Interactions

    Before taking any new medicine, either prescription or over-the-counter, check with your doctor or pharmacist. This includes supplements and herbal products.

    Dosage & Missed Dose

    Vistaril is available in two different capsules: a white and green capsule (50 mg) or a two-tone green capsule (25 mg).

    It also comes in a drinkable form (e.g., loose particles suspended in a liquid-filled vial) which needs to be shaken vigorously before use.

    If you skip a dose, take your next dose as soon as you remember. If it is time for your next dose, skip the missed dose and go back to your regular schedule. Do not double doses or take extra medicine to make up for the missed dose.


    Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (preferably not in the bathroom). Throw away any medication that is outdated or no longer needed.


    During early pregnancy, Vistaril should not be used. It is unknown if this medication is excreted in breast milk.

    More Information

    For more information, talk to your doctor, pharmacist or health care provider, or you can visit this website, for additional information from the manufacturer of this drug.

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    How we are treated: Atarax - Indicator

    How to turn the side effect of the drug into its main advantage, what GAD poisons our daily life and how histamine "distraction" helps us calm down, will tell the new issue of the column "How we are treated."

    Spring exacerbation this year is likely to await those suffering from anxiety disorders and panic attacks. Even normally calm people have more than enough reasons to worry. Nervous, many will think not only about proper nutrition, the distribution of rest and activity and sleep patterns, but also about medications that can come to the rescue in such a state. We have already discussed many popular anti-anxiety drugs, both Phenazepam from the benzodiazepine group, and their analogues, such as Stresam or Afobazol. Today we will talk about Atarax, which is considered by pharmacists as a mild tranquilizer and anti-anxiety agent.

    From what, from what

    Benzodiazepine drugs for anxiety, as we have already written more than once, are famous for a diverse bunch of undesirable effects - from memory and attention impairment to withdrawal syndrome. But our hero today does not belong to this common group. In contrast, hydroxyzine (namely, the name of the active ingredient of Atarax) is the first generation of antihistamines, which we usually treat allergic rhinitis, swelling or rashes. But inhibition of the nervous system and drowsiness - a side effect that drugs like Suprastin or even Zodak becomes a real curse - manufacturers have adopted. As a result, the side effect of Atarax (in which the same derivative, cetirizine, is formed in the body as the active ingredient in Zodak) won and is used as the main one.

    The main mechanism of action is that hydroxyzine is an inverse agonist of the h2-histamine receptor, that is, a protein that, after binding to histamine, triggers a series of reactions. Behind these terrible words is just that hydroxyzine binds to the same protein as histamine (one of the main "conductors" in allergic reactions and inflammation), and "distracts" this protein from interactions with its "believing". As a result, real histamine binds to the receptor protein worse, which should lead to the desired effect of the drug.

    But how does reducing the effect of histamine affect the brain? Cetirizine from a single 30 mg dose of hydroxyzine not only penetrates the brain, despite the blood-brain barrier protecting it from unwanted substances. Positron emission tomography images show that it binds to 67.6% of the brain's histamine receptors. This calms patients and makes them sleepy, while binding 20% ​​of the receptors is not enough for this effect. In addition, hydroxyzine acts (albeit weaker) on other receptors, including dopamine and serotonin. The same principle is based on the action of some drugs for depression and other mental disorders. But on muscarinic receptors, unlike many antihistamines, it does not show an effect, so it should pose less of a danger to people with heart disease.

    You can learn how to understand medicines on your own in the author’s online course “How we are being treated” by the editor of Indicator.Ru Ekaterina Mishchenko:

    process even our old friend alcohol dehydrogenase. The highest concentration of the drug in the blood (and the main effect) can be expected 2 hours after application, and it is excreted by half after 20 hours in adults, and after seven in children. In the elderly, these figures may differ, but the effect of the drug on them is poorly understood, so for them it may even have potentially dangerous side effects.

    Closer to the body

    All of these diverse mechanisms sound great, but do they work in large patient populations, or do they just change elusive biochemistry in limited human and animal experiments? The reasons for increased anxiety can be no less diverse, so let's deal with the indications, and clinical trials will help us in this.

    Atarax is prescribed for the treatment of itching, for the symptomatic control of anxiety before an upcoming operation (this is called premedication), for generalized anxiety disorder, psychomotor agitation, irritability, and even for chronic alcoholism. Since the drug has entered its seventh decade, it has been studied in great detail. In some areas, a lot of material has accumulated, and it has been systematized in reviews of the Cochrane Collaboration.

    The Cochrane Library is a database of the Cochrane Collaboration, an international non-profit organization involved in the development of World Health Organization guidelines. The name of the organization comes from the name of its founder, the 20th-century Scottish medical scientist Archibald Cochrane, who championed the need for evidence-based medicine and the conduct of competent clinical trials and wrote the book Efficiency and Efficiency: Random Reflections on Public Health. Medical scientists and pharmacists consider the Cochrane Database one of the most authoritative sources of such information: the publications included in it have been selected according to the standards of evidence-based medicine and report the results of randomized, double-blind, placebo-controlled clinical trials.



    The fight against itching in skin diseases caused by irritation or raging immunity (urticaria, dermatitis, eczema) is the work of Atarax in its original, antihistamine direction. And here it is used as a systemic medicine (by mouth, usually in the form of tablets). According to the conclusion of the authors of the Cochrane review, cetirizine (as we remember, hydroxyzine is converted into it in the body) in a standard dosage completely removes urticaria if you drink it in a short or medium course. The studies focused on redness and irritation (which is also itchy) that appeared spontaneously (for no apparent reason) and did not disappear for about six weeks without treatment.

    Eczema can become an even more unpleasant skin disease. The affected areas not only redden and itch, but also swell, can get wet and become covered with flaky crusts. For eczema, the benefit of antihistamines alone is not yet clear: they were usually used as part of complex treatment, so their effect is questionable. However, the authors urge not only to conduct new tests, but also not to refuse the use of antihistamines in the ensemble - it is likely that something will help.

    How gross is this anxiety of yours? Distinguishing causes, effects and making a diagnosis without medical help is quite difficult, so we will only briefly describe the options for which Atarax is prescribed.

    Generalized Anxiety Disorder (known in English as Generalized Anxiety Disorder, or GAD) refers to anxiety and worries that haunt a person constantly and sometimes for no particular reason, disrupting daily life. The patient may experience many symptoms: difficulty swallowing, difficulty sleeping, sweating, fearfulness, always feeling tired, constantly irritated, worrying about little things, trembling, or complaining of headaches. According to the Cochrane Review, hydroxyzine cannot be the number one drug candidate to fight GAD. Although it outperforms placebo in clinical trials, articles do not always provide detailed treatment results and the risk of misinterpretation of results is high. There are few studies, and the sample size in them is not very large. Although the review was published in 2010, little new data has been added since then. Nevertheless, he did not succumb to other anxiolytics (from English anxiety - anxiety).

    Double-blind, randomized, placebo-controlled method is a method of clinical drug research in which subjects are not privy to important details of the study being conducted. “Double-blind” means that neither the subjects nor the experimenters know who is being treated with what, “randomized” means that the distribution into groups is random, and placebo is used to show that the effect of the drug is not based on autosuggestion and that this medicine helps better than a tablet without active substance. This method prevents subjective distortion of the results. Sometimes the control group is given another drug with already proven efficacy, rather than a placebo, to show that the drug not only treats better than nothing, but also outperforms analogues.



    Another review (albeit dedicated to another drug) mentions hydroxyzine as a worthy competitor: it helps calm children before neurodiagnostic procedures. Hydroxyzine can also relieve pain during contractions, but there is very little data on this topic.

    PubMed's database of English-language articles also contains many articles on hydroxyzine and anxiety. True, they do not help dispel all doubts. Whether Atarax reduces anxiety before surgery is debatable. So, competing with alprazolam, hydroxyzine lost in reducing anxiety, but had the same sedative (calming, suppressing) effect. However, in all studies it is tested either in combination with other drugs (so which of them we owe the action is not clear), or compared with drugs that themselves may not be very effective for this indication. When compared with placebo, alas, the result turns into a pumpkin. Although the sample is small here too, so these results can be refuted if desired.

    Indicator.Ru recommends: for urticaria - yes, for anxiety - as an alternative

    For generalized anxiety disorder, Atarax is recommended if psychotherapy is not enough, and antidepressants did not work out. Nevertheless, it proved to be no worse than other anti-anxiety drugs in terms of efficacy, tolerability and safety. In other types of anxiety disorders or anxiety caused by real causes of anxiety, Atarax has been little studied.

    It is usually used either against allergic reactions, itching and hives (where it is, by the way, effective), or as a premedication - a sedative before surgery or other difficult medical intervention (where it is not very effective). While it is true that anxiety can exacerbate skin problems, continually creating new causes for concern, it is considered here as an antihistamine, but as a cure for anxiety is not in the first line of defense. It is not a barbiturate but is calming, not a benzodiazepine derivative but may help with anxiety.

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