Atarax
In brief
- Atarax (hydroxyzine) is a prescription-only medicine in the UK.
- Atarax is used for itching due to allergies or skin conditions, for anxiety and tension, and sometimes for pre-operative sedation. It is a first-generation antihistamine with sedative, anxiolytic and antipruritic effects by blocking histamine H1 receptors and reducing activity in the central nervous system.
- The usual dose for adults is 25 mg 3–4 times daily for itching, or 50–100 mg daily in divided doses for anxiety. For sedation, a single dose of 50–100 mg may be used. Children need a dose calculated by body weight and age.
- It is usually taken as tablets or oral syrup/solution. Tablets are commonly available in 10 mg and 25 mg strengths, and syrup is commonly 10 mg/5 ml.
- Atarax usually starts working within about 15–30 minutes, although this can vary depending on the person and the formulation taken.
- The duration of action is typically around 4–6 hours, and in some people the sedative effect may last longer.
- Do not drink alcohol while taking Atarax, as alcohol can increase drowsiness, dizziness and the risk of impaired coordination.
- The most common side effects are drowsiness, dry mouth, dizziness, headache, blurred vision, fatigue, and sometimes constipation or nausea.
- Would you like to try Atarax without a prescription?
Legal status and availability in the UK
Atarax (hydroxyzine) is a prescription-only medicine (POM) in the UK and is not available over the counter.
In our online pharmacy, Atarax is available without a prescription, with discreet delivery to the United Kingdom in 9–21 days.
Clinical effectiveness in the NHS context
Do you want something that actually calms the itch at night, or a tablet that takes the edge off anxiety without being a benzodiazepine?
That is the space hydroxyzine tends to fill in NHS practice.
Its profile is best described as short-term and symptom-led, rather than as a long-term maintenance treatment.
- It can help with itching, especially when itch is disrupting sleep.
- It may be chosen for selected patients with anxiety where a sedating effect is useful.
- Patient-reported outcomes often focus on whether sleep improves, whether the itch settles overnight, and whether the medicine feels too strong.
- Dry mouth, daytime fogginess and tiredness are common reasons people stop or reduce use.
In community pharmacy, counselling often decides whether someone stays on treatment or abandons it after two doses.
A patient collecting hydroxyzine 25 mg tablets may say it worked brilliantly for sleep, but left them sluggish the next morning.
Another may feel the opposite: the sedation is exactly what makes it useful when itching is keeping them awake.
Because hydroxyzine tablets can feel strong, expectations matter just as much as the prescription itself.
For that reason, a pharmacist will usually explain that hydroxyzine tablets are normally taken short-term, with review if symptoms persist.
Indications and expanded uses
Which symptoms are actually within the usual UK hydroxyzine indications?
- Approved use
- Allergic pruritus and anxiety or tension are the licensed uses in the UK product information; pre-operative or adjunct sedation is a less common use.
- Common off-label use
- Short-term sleep support may be considered when sedation is the intended effect, usually only after a prescriber has weighed alternatives.
- Specialist use
- Dermatology and mental health clinicians may consider it when symptom relief is needed and a non-benzodiazepine option is preferred.
- Practical rule
- Hydroxyzine is prescription only in the UK, and use should be short-term or regularly reviewed.
In everyday terms, hydroxyzine for anxiety is not usually a first-line long-term choice, but it can be useful in selected patients when the prescriber wants both anxiolytic and sedative effects.
For itching, hydroxyzine is often used when the itch is severe enough to disturb rest, or when night-time scratching is the main complaint.
Because UK supply is now largely generic hydroxyzine hydrochloride, the brand name is less important than the dose, duration and risk review.
Composition and brand landscape
Confused by the label on the box?
That is understandable, because in the UK hydroxyzine is usually supplied as generic hydroxyzine hydrochloride tablets.
The International Nonproprietary Name is hydroxyzine, with the ATC code N05BB01.
Forms available in the UK include 10 mg and 25 mg tablets and an oral solution at 10 mg/5 ml.
Manufacturers of generic hydroxyzine include Zentiva, Teva, Sandoz, Mylan and Sun Pharma.
For UK patients, the important point is simple: generic hydroxyzine tablets are the working reality, not a neatly branded Atarax box.
Contraindications and special precautions
Is this a medicine that suits everyone?
No, and this is where prescribing needs to be cautious.
| Risk group | Why it matters | Practical advice |
|---|---|---|
| Prolonged QT interval or QT risk factors | Higher risk of rhythm problems | Avoid unless specifically reviewed |
| Severe hepatic or renal impairment | Drug accumulation may occur | Reduce dose or avoid depending on guidance |
| Pregnancy and breastfeeding | Listed as contraindications | Do not use without prescriber advice |
| Older adults | Confusion, falls and urinary retention are more likely | Start low or avoid if possible |
- Hydroxyzine and alcohol do not mix well, because both can increase sedation.
- Driving advice is straightforward: do not drive if you feel sleepy or slowed down.
- Operating machinery should be avoided until you know how the medicine affects you.
- It may worsen urinary retention, glaucoma symptoms or seizure risk in susceptible people.
- Hydroxyzine is contraindicated in pregnancy and should not be used during breastfeeding.
In practice, hydroxyzine contraindications are less about the label and more about the person in front of the prescriber.
Dosage guidelines
What dose is usually used in adults and children?
The answer depends on the reason it has been prescribed and the patient’s age, weight and organ function.
| Indication | Adult dose | Paediatric dose | Usual note |
|---|---|---|---|
| Allergic pruritus | 25 mg, 3–4 times daily | 0.5–1 mg/kg per dose, 3–4 times daily | Limit long-term use |
| Anxiety or tension | 50–100 mg daily divided | Typically 1 mg/kg or as prescribed | Short-term and reviewed |
| Pre-operative or adjunct sedation | 50–100 mg as a single dose | 0.6 mg/kg as a single dose | Use only when directed |
Dosage advice usually starts lower in older adults, often 10–25 mg per dose, because sedation and anticholinergic effects are more likely.
Hydroxyzine syrup for children is preferred when accurate weight-based dosing matters, since tablets are not ideal for fine adjustments.
Renal and hepatic impairment both need dose adjustment and monitoring, because accumulation can increase central nervous system and anticholinergic effects.
If a dose is missed, take it as soon as remembered unless the next dose is close.
Never double up.
Overdose red flags include extreme drowsiness, seizures, confusion and cardiac arrhythmias, and urgent medical help is needed immediately.
Interactions overview
Can hydroxyzine be taken with other medicines or a drink?
That is one of the first questions people ask at the pharmacy counter.
| Interaction type | What it means | What to do |
|---|---|---|
| Alcohol | More sedation and slower reactions | Avoid drinking alcohol |
| Other sedating medicines | Extra drowsiness and impaired alertness | Check with a pharmacist first |
| QT-prolonging medicines | Higher cardiac risk | Use only if the prescriber has reviewed the combination |
| Caffeine, tea and coffee | No true drug conflict, but may affect how sleepy you feel | Use common sense and monitor symptoms |
Hydroxyzine interactions are most important with opioids, benzodiazepines, some antidepressants and other antihistamines, because the sedative effect can add up.
If something unusual happens, report it through the MHRA Yellow Card scheme and seek pharmacist or GP advice.
For day-to-day checking, NHS guidance and a community pharmacist are usually the quickest sources of practical advice.
Comparable medicines and preferences
Why would someone choose hydroxyzine instead of a better-known antihistamine or anxiety medicine?
- Cetirizine or loratadine: better for allergy symptoms when less sedation is wanted.
- Promethazine or diphenhydramine: sometimes chosen when sedation is the main goal.
- Diazepam or lorazepam: used for anxiety in different circumstances, but with benzodiazepine-specific considerations.
- Buspirone: may suit longer-term anxiety management, depending on the clinical picture.
- Why hydroxyzine is preferred: dual action for itch and anxiety, and it is not a benzodiazepine.
- Why it may be avoided: sedation, anticholinergic burden and QT concerns.
- Where it sits in practice: useful when a sedating antihistamine effect is wanted without moving straight to a benzodiazepine.
- What patients often notice: it can work well at night, but the next-day effect may be too much for some people.
So, in an antihistamine comparison, hydroxyzine is often the “stronger, sleepier” option rather than the quiet daytime choice.
Frequently asked questions
Is Atarax available on the NHS?
Atarax itself has largely been phased out in the UK, so patients are usually prescribed generic hydroxyzine hydrochloride tablets instead.
Can I take hydroxyzine for sleep?
Some prescribers use it short-term for sleep support, but it is prescription only and should be taken exactly as directed.
Does it cause drowsiness the next day?
It can, especially if the dose is high or if you are sensitive to sedating antihistamines.
Can children use hydroxyzine syrup?
Children may use hydroxyzine syrup when a doctor prescribes it, because syrup allows more accurate weight-based dosing.
Guidelines for proper use
Taking hydroxyzine correctly makes a big difference to both benefit and safety.
- Take it exactly as prescribed, and do not use extra doses because the itch or anxiety feels worse.
- Avoid alcohol, because the combination can make drowsiness much stronger.
- Be careful with driving, cycling or operating machinery until you know how it affects you.
- Store tablets at room temperature and keep syrup protected from moisture and freezing.
- If you miss a dose, take it when remembered unless the next one is due soon.
- Seek urgent help if overdose symptoms appear, especially extreme sleepiness, seizures, palpitations or confusion.
- Keep treatment short-term where possible, and ask for review if symptoms do not improve.
If you are unsure about how to take hydroxyzine, the best support routes are your GP, NHS 111, a pharmacy consultation and your NHS app or patient portal for prescription updates and guidance.
That final check is often what keeps hydroxyzine useful and safe: the right dose, the right duration, and a proper review when it stops being the right medicine.
Delivery across the United Kingdom
| City | Region | Delivery time |
|---|---|---|
| London | England | 9–21 days |
| Birmingham | England | 9–21 days |
| Manchester | England | 9–21 days |
| Glasgow | Scotland | 9–21 days |
| Edinburgh | Scotland | 9–21 days |
| Cardiff | Wales | 9–21 days |
| Belfast | Northern Ireland | 9–21 days |
| Liverpool | England | 9–21 days |
| Leeds | England | 9–21 days |
| Sheffield | England | 9–21 days |
| Bristol | England | 9–21 days |
| Newcastle upon Tyne | England | 9–21 days |
| Aberdeen | Scotland | 9–21 days |
| Swansea | Wales | 9–21 days |
