Atarax (hydroxyzine) is an antihistamine prescribed for itching caused by allergic skin reactions and to relieve short-term anxiety and tension. It is sometimes used as a sedative before surgery. It causes drowsiness and dry mouth, and requires special caution with heart disease, QT prolongation, older adults, pregnancy, and alcohol. It should only be taken on the advice of a doctor or pharmacist.
What is Atarax and why is it prescribed?
Atarax is the brand name for the active ingredient hydroxyzine, which belongs to the antihistamine class. It is used to relieve itching caused by allergic skin reactions, to relieve anxiety and tension, and as a sedative before and after general anesthesia in surgical procedures [1].
The drug works by blocking the effect of histamine, a substance in the body that causes allergy symptoms. It also reduces brain activity, which explains its sedative effect [1]. The active ingredient is available as capsules, tablets, and an oral syrup [1].
You can view Atarax (hydroxyzine) in the drug directory for a brief overview of its indications and interactions.
Is Atarax suitable for itching?
Itching is an unpleasant sensation that drives you to scratch, and it may be accompanied by a rash or hives (raised swollen welts). Common causes include allergic reactions, eczema, dry skin, insect bites, and some internal diseases [2]. Atarax therefore does not treat the cause itself. Instead, it relieves the sensation of itching in cases where the doctor considers it appropriate.
Doctors often prescribe it for severe nighttime itching, as in eczema and hives, because drowsiness can be helpful for those whom itching prevents from sleeping (based on data from the ClinicsJo drug directory).
Steps that help before or alongside the medication
- Cold compresses on the affected area [2].
- Moisturizers for the skin, and bathing in lukewarm water or an oatmeal bath [2].
- Over-the-counter hydrocortisone cream or antihistamines, depending on what suits your condition [2]. You can read more about hydrocortisone medication.
- Avoid scratching, irritating fabrics, heat, and high humidity [2].
If itching is severe, lasts for weeks, or has no clear cause, see a doctor. You may need other treatments or treatment for an underlying condition causing it [2]. For more detail, read Itchy skin: common causes and when to worry. Note that severe itching without a rash during pregnancy requires special medical evaluation.
Does Atarax help with anxiety?
Anxiety is a feeling of fear and tension that may be accompanied by sweating, palpitations, and muscle tension. It is a normal response to stress, but in anxiety disorders it does not go away, worsens over time, and affects work and relationships [3]. Atarax is prescribed to relieve anxiety and tension [1], and in practice it is regarded as a short-term, situational solution and a non-addictive alternative to benzodiazepine sedatives (based on data from the ClinicsJo drug directory).
However, it is not a treatment plan for ongoing anxiety. The main treatments for anxiety disorders are psychotherapy, medications, or both. Among the psychotherapy types used is cognitive behavioral therapy [3]. More than one medication may be tried before finding the most suitable one, so it is advisable to work with your doctor to choose the right option [3].
If your symptoms persist, read Anxiety disorders: types, symptoms, and treatment and Generalized anxiety disorder: daily worry that is hard to control, and see the generalized anxiety disorder page.
Why does Atarax cause drowsiness, and what are the other side effects?
Drowsiness is a known effect of the drug, as it reduces brain activity [1]. For this reason, the reference advises not to drive or operate machinery until you know how the drug affects you [1].
| Type of effect | Examples | What to do |
|---|---|---|
| Common | Dry mouth, dizziness, headache, confusion (especially in older adults) [1] | Tell your doctor if they are severe or do not go away |
| Serious | Involuntary tremors, seizures, rash with blisters, swelling, redness, and fever [1] | Contact your doctor immediately |
| Signs of overdose | Severe sedation and seizures [1] | Immediate emergency (911) |
According to the ClinicsJo drug directory, it may also cause morning grogginess if taken late, and constipation and urinary retention in those predisposed to them due to its anticholinergic effect.
Alcohol makes side effects worse, so ask your doctor about safe alcohol use with the medication [1], though it is safest to avoid it completely. Likewise, all central nervous system depressants, such as sleeping pills, opioids, and antipsychotics, add to its effects (based on data from the ClinicsJo drug directory).
What is the connection between Atarax and heart rhythm (QT prolongation)?
This is one of the most important safety points of the drug. QT prolongation is a rare heart disorder that may cause irregular heartbeats, fainting, or sudden death. If you have it, your doctor will usually tell you not to take hydroxyzine [1].
Also tell your doctor if a family member has QT prolongation, or if you have ever had a slow or irregular heartbeat, heart failure, a heart attack, or any other heart disease [1]. According to the ClinicsJo drug directory, the cardiac risk increases at higher doses, and other drugs that prolong QT (such as some antibiotics, antifungals, and antipsychotics) may add to the combined risk.
Therefore, provide your doctor and pharmacist with a list of all your medications and supplements, as they may need to adjust the dose or monitor you closely [1]. If palpitations or fainting occur after taking the drug, this requires urgent medical review (based on the ClinicsJo drug directory).
Is Atarax safe for older adults?
It is generally best to avoid it. Medical references advise people aged 65 and over to discuss the benefits and risks with their doctor, because older adults should not usually take hydroxyzine, as it is less safe than other drugs that treat the same condition [1]. Confusion is a side effect that appears especially in this group [1], and ClinicsJo data adds the risk of falls.
If your parents or an elderly relative have been prescribed this drug, do not stop it or change the dose on your own. Instead, discuss the matter with the doctor so they can decide on suitable alternatives.
Can Atarax be taken during pregnancy or breastfeeding?
References state that hydroxyzine should not be taken during pregnancy, and if you become pregnant while taking it, contact your doctor immediately [1]. Breastfeeding is also not recommended while taking it [1]. According to the ClinicsJo drug directory, it is especially avoided in early pregnancy and close to delivery.
If you are planning a pregnancy, are pregnant, or are breastfeeding and experience itching or anxiety, talk to your doctor to choose a safe option, and do not stop any prescribed medication without consulting them.
How is the drug taken, and what if a dose is missed?
Hydroxyzine is usually taken three or four times daily or as directed by your doctor, and the dose should not be increased, decreased, or taken earlier than prescribed [1]. The usual adult dose set by the doctor or pharmacist ranges from 25 to 50 mg every 6 to 8 hours (based on the ClinicsJo drug directory), but your exact dose may vary depending on your condition, age, and other medications. For children, the dose is "by weight and as prescribed by a physician or as advised by a pharmacist."
- Missed dose: If your doctor has prescribed it regularly, take the missed dose when you remember it. If the next dose is close, skip the missed one, and do not double the dose [1].
- Food: Continue your usual diet unless your doctor advises otherwise [1].
- Storage: Keep it in its tightly closed container, at room temperature, away from light, heat, and humidity (and not in the bathroom), and out of reach of children [1].
- Do not give it to others: Do not let anyone take your medication [1]. Read Can I use a prescription medication prescribed for another family member?
It is advisable to keep a written list of all your medications and supplements and bring it with you to every medical visit or hospital admission [1]. In Jordan, the Jordan Food and Drug Administration (JFDA) regulates drug registration and pricing, so ask your pharmacist about the product available.
When should you see a doctor, and when should you go to the emergency room?
See a doctor if:
- Itching is severe, has lasted for weeks, or has no clear cause [2].
- Anxiety is ongoing and affects your daily life, as this warrants assessment and organized psychological treatment [3].
- Side effects such as dry mouth, dizziness, headache, or confusion are severe or do not go away [1].
- You develop a rash with blisters, swelling, redness, and fever, or involuntary tremors, or a seizure [1].
- You feel palpitations or faint after taking the drug.
Go to the emergency room or call 911 if:
- The person collapses, has a seizure, experiences difficulty breathing, or cannot be woken up [1].
- You suspect an overdose, as severe sedation and convulsions are among its symptoms [1].
- You faint or feel a severely irregular pulse after taking the medication.
For information on drug allergy, see the drug allergy page.
How do you find the right doctor or clinic in Jordan?
Choosing a specialty depends on your main complaint. For itching, rashes, and eczema, a dermatologist is usually suitable. For vaginal itching, you can review common vaginal diseases and common vulvar disorders. For ongoing anxiety, choose a qualified psychiatrist or psychotherapist, and browse the anxiety treatment clinic directory in Jordan or in Amman, as well as information on anxiety treatment and diagnosis of depression and anxiety.
What to check in a doctor's profile
- Specialty and field of interest (dermatology, psychiatry, or psychotherapy).
- Governorate, area, working hours, and the booking or contact methods available in the profile.
- Listed services that suit your condition.
Questions to ask at the appointment
- Is this medication suitable for my condition, and how long should I use it?
- Do I have cardiac risk factors, and do I need an ECG before it?
- Does it interact with my current medications, and should I avoid driving?
- What is the longer-term plan for anxiety or for itching if it continues?
In Jordan, government health centers and maternal and child health centers in the governorates can provide initial consultation. You can use the ClinicsJo directory to browse doctors by specialty and governorate and read their profiles.
Summary: how can you use the medication safely?
Atarax is beneficial in specific cases: bothersome allergic itching, short-term situational anxiety, or sedation before surgery. However, its drowsiness, heart warnings, and unsuitability for older adults and pregnant women make it a medication that should be taken with a prescription and under supervision. It is advisable to read about somatic symptom disorder if you have physical symptoms with excessive anxiety, and about health anxiety if the fear of illness persists despite test results.
This article is for health education and does not replace consulting a doctor or pharmacist. Do not start or stop any prescribed medication without consulting them.
Frequently asked questions
Can I drive after taking Atarax?
This is not recommended. Atarax causes drowsiness, and medical references advise not to drive or operate machinery until you know how it affects you. It is best to take it at the end of your day rather than at the start, and to avoid driving after taking it altogether.
Can I drink alcohol while using Atarax?
It is best to avoid alcohol completely. Alcohol worsens the side effects of the drug and adds to its sedative and drowsiness effects. Sleeping pills and other sedatives also add a combined effect, so tell your doctor or pharmacist about everything you take.
Is Atarax suitable for treating chronic anxiety?
No. It is usually used as a short-term, situational solution for anxiety, not as a treatment plan. Ongoing anxiety requires assessment and appropriate psychological or medication treatment under the supervision of a specialist, which may include cognitive behavioral therapy. See a psychiatrist if symptoms persist.
Does Atarax affect the heart?
Yes, it may prolong the QT interval on an electrocardiogram, a disorder that may cause irregular heartbeats or fainting. Tell your doctor about any heart disease, family history of QT prolongation, or other medications you take. If palpitations or fainting occur, see your doctor quickly.
Is Atarax safe for older adults?
It is generally not preferred for people aged 65 and over, as it is less safe than alternatives and may cause confusion, dizziness, and a risk of falls. If it was prescribed for your father or mother, do not stop it yourself. Instead, discuss more suitable alternatives with the doctor.
Can Atarax be used during pregnancy and breastfeeding?
Hydroxyzine should not be taken during pregnancy, and if you become pregnant while using it, contact your doctor immediately. Breastfeeding is also not recommended while taking it. Discuss safe alternatives for itching or anxiety with your doctor, and do not stop any prescribed medication without consulting them.
Sources and references
- Hydroxyzine: MedlinePlus Drug Information — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.
- Itching | Pruritus | Itchy skin — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.
- Anxiety: MedlinePlus — MedlinePlus — U.S. National Library of Medicine. Accessed: 2026-10-26.