Comprehensive medication guide to Hydroxyzine including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$20 copay for generic hydroxyzine on most plans; Tier 1 on nearly all Medicare Part D, Medicaid, and commercial formularies. Prior authorization is not typically required.
Estimated Cash Pricing
$15–$45 retail for a 30-day supply of generic hydroxyzine; as low as $5–$11 with GoodRx or SingleCare coupons. Hydroxyzine pamoate capsules run slightly higher than hydroxyzine HCl tablets.
Medfinder Findability Score
72/100
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Hydroxyzine is a first-generation antihistamine in the piperazine chemical family, used as an anxiolytic, antipruritic, and sedative. Originally approved in 1956, it is one of the oldest psychiatric and allergy medications still in widespread use — and one of the most widely prescribed drugs in the United States, with over 15 million prescriptions written annually.
It was formerly sold under the brand names Atarax (hydroxyzine hydrochloride) and Vistaril (hydroxyzine pamoate), both of which have been discontinued. Only generic versions are currently available in the US.
FDA-approved uses include: anxiety and tension associated with psychoneurosis, allergic pruritus (chronic urticaria, atopic and contact dermatoses), pre- and post-surgical sedation, and nausea and vomiting. It is also commonly used off-label for insomnia and alcohol withdrawal anxiety.
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Hydroxyzine works through several mechanisms simultaneously. Its primary action is blocking H1 histamine receptors throughout the body and brain. In peripheral tissues, this reduces allergic symptoms like itching and hives. In the brain, blocking histamine receptors in the tuberomammillary nucleus (the main source of brain histamine) reduces wakefulness signals, causing sedation.
Hydroxyzine also blocks 5-HT2a serotonin receptors, which contributes to its anxiolytic effects independently of sedation. This is why clinical studies show hydroxyzine outperforms placebo for generalized anxiety disorder — and why it helps with anxiety even at doses that don't cause significant sedation.
Hydroxyzine is rapidly absorbed orally — clinical effects are usually noted within 15 to 30 minutes. Its primary active metabolite is cetirizine (the active ingredient in Zyrtec), which explains the related antihistamine effects of both drugs. Hydroxyzine also has mild anticholinergic activity, which explains side effects like dry mouth and constipation.
10 mg — tablet
Hydroxyzine HCl 10 mg tablet — lowest dose, used for mild anxiety or as starting dose
25 mg — tablet
Hydroxyzine HCl 25 mg tablet — most commonly prescribed and most widely stocked dose
50 mg — tablet
Hydroxyzine HCl 50 mg tablet — for moderate to severe anxiety or pruritus
25 mg — capsule
Hydroxyzine pamoate 25 mg capsule (Vistaril generic) — equivalent to HCl form
50 mg — capsule
Hydroxyzine pamoate 50 mg capsule (Vistaril generic)
100 mg — capsule
Hydroxyzine pamoate 100 mg capsule — higher dose, less commonly stocked
10 mg/5 mL — oral solution
Hydroxyzine HCl oral syrup — commonly used for pediatric patients; availability gaps more frequent
Oral hydroxyzine (tablets and capsules) is generally available in 2026 — there is no active FDA-declared national shortage. Multiple generic manufacturers including Amneal, Avet, Sandoz, Chartwell, and Teva supply the market. However, patients frequently report difficulty finding specific doses or forms at their usual pharmacy.
Localized stockouts occur due to rising prescription demand, fragmented generic supply chains, and uneven pharmacy stocking. The 25 mg tablet is the most broadly available form. The oral syrup (10 mg/5 mL) and 100 mg capsules see the most frequent availability gaps. The hydroxyzine HCl injection has a history of documented supply disruptions.
If your pharmacy doesn't have hydroxyzine in stock, try multiple locations — availability varies significantly between pharmacies in the same area. medfinder calls pharmacies near you to check which ones have your specific medication in stock and texts you the results, saving you from calling each pharmacy yourself.
Because hydroxyzine is not a controlled substance, any licensed prescriber with prescribing authority can write a hydroxyzine prescription without special DEA requirements or registrations. There is no need for a specialist referral.
Hydroxyzine is widely available through telehealth platforms in 2026. Because it is not a controlled substance, it can be prescribed via video or phone visit without in-person examination requirements. Major platforms including Teladoc, MDLive, Amazon Clinic, and mental health-focused services can prescribe it for appropriate indications.
No. Hydroxyzine is not a controlled substance. It is not scheduled by the DEA under the Controlled Substances Act. This is one of hydroxyzine's most important clinical distinguishing features compared to benzodiazepines (which are Schedule IV) and other anxiety medications.
Because it is not controlled: any licensed prescriber (physician, NP, PA) can prescribe it; there are no DEA prescribing requirements; it can be prescribed via telehealth without in-person visit requirements; prescriptions can be sent electronically or called in to pharmacies without special restrictions; and there is no limit on refills imposed by DEA scheduling.
Hydroxyzine has no established abuse potential or physical dependence risk, which is why it is often preferred over benzodiazepines for patients with anxiety who have a history of substance use disorder.
Common side effects include:
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Buspirone (BuSpar)
Non-controlled anxiolytic for chronic GAD; takes 2-4 weeks to work; no sedation; no abuse potential
Cetirizine (Zyrtec)
OTC second-generation antihistamine; hydroxyzine's primary metabolite; effective for allergies with minimal sedation
Sertraline (Zoloft)
First-line SSRI for chronic anxiety and depression; takes 4-6 weeks; non-sedating
Lorazepam (Ativan)
Benzodiazepine; fast-acting; Schedule IV controlled substance with addiction risk; for short-term use only
Trazodone
Antidepressant used off-label for sleep; non-addictive; commonly used as a hydroxyzine alternative for insomnia
Prefer Hydroxyzine? We can find it.
Opioids (fentanyl, morphine, oxycodone)
majorAdditive CNS and respiratory depression; significantly increases overdose risk; avoid combination or use lowest possible doses with extreme caution
Benzodiazepines (alprazolam, diazepam, lorazepam)
majorAdditive CNS depression; increased sedation and respiratory depression risk; generally avoid
QT-prolonging drugs (amiodarone, citalopram, fluoxetine, azithromycin, antipsychotics)
majorAdditive QT prolongation; increased risk of torsades de pointes; monitor or avoid
Alcohol
majorSignificant additive CNS depression; increased sedation, impaired coordination, falls risk; avoid
Other antihistamines (diphenhydramine, doxylamine)
moderateAdditive anticholinergic and sedative effects; increased risk in elderly
Grapefruit juice
moderateInhibits CYP3A4 metabolism of hydroxyzine, raising blood levels and QT prolongation risk
Anticholinergic drugs (TCAs, oxybutynin)
moderateAdditive anticholinergic effects: dry mouth, constipation, urinary retention, confusion (especially in elderly)
Hydroxyzine is a well-established, affordable, and non-addictive medication with a 70-year track record. Its combination of antihistamine, anxiolytic, and sedative properties makes it uniquely versatile, and its non-controlled status makes it accessible without the prescribing restrictions and monitoring requirements of benzodiazepines.
While oral hydroxyzine is generally available in 2026, growing demand and a fragmented generic supply chain mean that some pharmacies run out of stock — particularly for specific doses and forms. The key for patients is to know their options: try multiple pharmacies, consider formulation flexibility (HCl vs. pamoate), and plan refills in advance.
If you're having trouble finding hydroxyzine in stock, medfinder can help. Just provide your medication details and location, and medfinder calls pharmacies near you to find which ones have it in stock — then texts you the results.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
Real-time availability
Medfinder is actively checking pharmacy inventory for Hydroxyzine. We don't publish a number until we have enough verified pharmacy checks to be accurate — start a search and our team confirms current availability near you, usually within 24 hours.
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