Hydroxyzine is an antihistamine medication often prescribed to alleviate symptoms of anxiety, tension, and allergic reactions. It is also used as a sedative for various purposes. However, combining hydroxyzine with alcohol is generally not considered safe and is strongly discouraged due to the potential for significant and dangerous interactions.
Hydroxyzine and Its Effects
Hydroxyzine, available under brand names like Vistaril and Atarax, is primarily an antihistamine that works by blocking the effects of histamine, a natural chemical in the body. This action helps to reduce symptoms such as itching and hives associated with allergic skin reactions. Beyond its antihistamine properties, hydroxyzine also acts on the central nervous system (CNS).
It decreases brain activity, contributing to its use in managing anxiety and tension. The medication can also be utilized for its sedative properties. While effective for these conditions, common side effects of hydroxyzine itself can include drowsiness, dry mouth, and headaches.
Alcohol and Its Effects
Alcohol is classified as a central nervous system (CNS) depressant, meaning it slows down brain activity. When consumed, alcohol can influence mood, behavior, and self-control, leading to impaired memory and reduced clarity of thought. It also affects coordination and physical control.
Alcohol exerts its depressant effects by enhancing the activity of certain neurotransmitters, such as gamma-aminobutyric acid (GABA), which can lead to feelings of calmness and sedation.
The Dangers of Combining Hydroxyzine and Alcohol
Combining hydroxyzine and alcohol poses significant risks primarily because both substances are central nervous system depressants. Their combined effect is synergistic, meaning the impact is greater than the sum of their individual effects. This amplified CNS depression can lead to severe and unpredictable consequences.
One of the most common dangers is a substantial increase in drowsiness and sedation. This can impair coordination and motor skills, increasing the risk of falls and accidents. Individuals may also experience heightened dizziness, confusion, and difficulty concentrating, making it unsafe to perform tasks requiring alertness.
More severe risks include respiratory depression, where breathing becomes slowed or shallow, and an increased potential for fainting. The combination can also worsen underlying anxiety and mood-related issues, despite hydroxyzine’s use for anxiety. Additionally, both substances are metabolized by the liver, and their combined use can strain liver function.
In extreme cases, mixing hydroxyzine and alcohol can lead to an accidental overdose, characterized by unresponsiveness, convulsions, or severe vomiting. Heart problems, such as abnormal heart rhythms and low blood pressure, can also occur. Healthcare professionals and the U.S. Food and Drug Administration (FDA) warn against this combination.
Safe Practices and When to Seek Help
Given the significant risks, it is advised to avoid alcohol entirely while taking hydroxyzine. While hydroxyzine’s noticeable effects may wear off in about 4 to 6 hours, the medication itself remains in the body for a much longer period. The average half-life of hydroxyzine in adults is approximately 20 hours.
It typically takes about five half-lives for a medication to be fully cleared from the body, meaning hydroxyzine can remain in your system for up to 100 to 125 hours after the last dose. Therefore, it is generally recommended to wait at least 48 hours, and preferably 2 to 3 days, after your last dose of hydroxyzine before consuming any alcohol. This extended waiting period helps ensure most of the medication has been eliminated.
Individual factors such as age, liver function, and kidney health can influence how quickly hydroxyzine is processed. If someone accidentally combines hydroxyzine and alcohol and experiences severe drowsiness, difficulty breathing, a rapid heart rate, seizures, or unresponsiveness, immediate medical attention is necessary. Consulting a healthcare provider for personalized advice on medication and alcohol use is always recommended.