Hydroxyzine Pamoate vs Hydroxyzine

Introduction

Hydroxyzine Pamoate and Hydroxyzine HCL belong to a class of drugs called antihistamines. These drugs restrict histamine production in the body to treat anxiety, tension, itching, allergic reactions, and conditions associated with psychoneurosis.[1] Histamine is a chemical produced in the body due to allergic interactions. While both drugs work on the same purpose and have the same active ingredient (Hydroxyzine), they vary slightly based on how a patient’s body reacts. Sometimes, doctors prescribe them to treat different conditions associated with the same root cause.

About Hydroxyzine Pamoate and Hydroxyzine

What is Hydroxyzine Pamoate?

Hydroxyzine Pamoate is an antihistamine and an anticholinergic prescribed for treating anxiety and tension. The drug has sedative properties that help relieve anxiety and allergic reactions like hives and contact dermatitis.[2] Hydroxyzine Pamoate is available under different brand names, with Vistaril being a popular one. The drug has effective results in most patients and comes in the following forms.

Capsules
Liquid

What conditions is Hydroxyzine Pamoate approved to treat?

Hydroxyzine Pamoate is an effective drug for anxiety and allergies. Doctors prescribe it to patients for short-term anxiety relief, itch relief, and to promote sedation. Here are the conditions this antihistamine drug can treat.[3]

Anxiety
Itching
Hives
Eczema
Contact Dermatitis

The drug is highly effective for patients sensitive to allergic reactions. It is a prescription drug and may be thoroughly checked for contraindications and drug interactions before use.

How does Hydroxyzine Pamoate work for anxiety?

Hydroxyzine Pamoate works on two important chemicals in the body: histamine and serotonin. Belonging to antihistamines, the drug blocks the effects of histamine in the patient’s body when taken in prescribed doses.[4] Additionally, it acts as a serotonin antagonist and boosts the serotonin levels in the brain by restricting it from being absorbed into the nerves. The collective action relieves anxiety and tension and promotes sedation.

What is Hydroxyzine?

Hydroxyzine HCL is an antihistamine and an anticholinergic used to treat symptomatic anxiety, tension, and conditions associated with psychoneurosis.[5] Doctors prescribe this drug to patients having allergic reactions such as itching. Hydroxyzine HCL was formerly available under the brand name Atarax. However, the medicine was discontinued later. The drug differs from Hydroxyzine Pamoate (primarily) based on its available forms. You may find it in the following forms.

Tablets
Liquids

What conditions is Hydroxyzine approved to treat?

Hydroxyzine HCL is an effective medication for treating anxiety and allergic reactions.[6] Doctors prescribe it to patients having allergic reactions. Since Hydroxyzine HCL and Hydroxyzine Pamoate work for the same purpose, they treat the same conditions as mentioned below.

Anxiety
Itching
Hives
Eczema
Contact Dermatitis

How does Hydroxyzine work for anxiety?

Hydroxyzine HCL enters the human body to restrict the activity of histamine. When a patient has anxiety or faces an allergic reaction, the medication acts as a barrier between the symptom-promoting histamine and the patient’s stability. Hindering the production of histamine relieves anxiety and allergy while causing sedating effects for healthy sleep.

Effectiveness

How effective are Hydroxyzine Pamoate and Hydroxyzine for treating anxiety?

As mentioned earlier, Hydroxyzine Pamoate and Hydroxyzine are two forms of the same drug formulation. Both drugs vary based on their forms in the drug market. Since the two medications have the same main component (Hydroxyzine) and different salts (combined with the main component), their effectiveness varies for each patient. However, there is limited evidence as to how these drugs differ in terms of their plan of action.

A study conducted to evaluate the efficacy and safety of Hydroxyzine HCL highlighted that the drug was effective in treating numerous allergic and inflammatory conditions. The results showed that the medication was well-tolerated, and all side effects diminished once the treatment was over.[7]

A recent study highlighted the effectiveness of Hydroxyzine (the primary component of both drugs) in reducing anxiety symptoms in adults. According to the results, Hydroxyzine has a small to moderate effect in treating generalized anxiety disorder when compared with placebo.[8] Moderation of benefits may be due to varied body responses to the use of drugs.

In a different study, researchers evaluated the effectiveness of Hydroxyzine Pamoate (Vistaril) in treating anxiety neurosis. The findings of the comparative study highlighted improvements in patients, with improved sleep being a notable effect.[9] Overall, both forms of Hydroxyzine are effective in treating anxiety, with a few exceptions.

Dosage information

How is Hydroxyzine Pamoate administered for anxiety?

Hydroxyzine Pamoate dosage information

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How is Hydroxyzine administered for anxiety?

Hydroxyzine dosage information

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Side Effects

What are the most common side effects of Hydroxyzine Pamoate?

The most common side effects of Hydroxyzine Pamoate include the following.

Dry Mouth
Drowsiness
Tremor
Headache
Hallucination

These symptoms are (generally) transitory and may disappear after a few days of oral doses or after stopping the treatment.

Are there any potentially serious side effects of Hydroxyzine Pamoate?

Although not common, Hydroxyzine Pamoate may cause some serious side effects in certain patients after oral consumption.[10] Patients are advised to contact their doctor immediately if they notice any of the following symptoms.

Allergic Reactions
Long QT Syndrome
Torsades De Pointes

What are the most common side effects of Hydroxyzine?

The most common side effects of Hydroxyzine HCL are covered below.

Nausea
Tremor
Drowsiness
Dry Mouth
Headache
Hallucination

Please note that the side effects of Hydroxyzine Pamoate and Hydroxyzine HCL are similar and may go away after a few doses or stopping the treatment.

Are there any potentially serious side effects of Hydroxyzine?

Hydroxyzine HCL is a histamine inhibitor and may cause some serious side effects in certain patients when taken in prescribed doses. If you notice any of the following symptoms, you may reach out to your doctor at the earliest for help.[11]

Chest Pain
Cough
Swallowing Difficulty
Fainting
Pounding Heartbeat
Hives (or other allergic reactions)
Puffiness of the Eyes, Lips, or Tongue
Breathing Difficulty

Contraindications and Interactions

Warnings and general precautions for Hydroxyzine Pamoate and Hydroxyzine

Hydroxyzine Pamoate and Hydroxyzine HCL both have sedative effects. Patients should be careful about driving and self-managed activities due to the possibility of drowsiness. Moreover, these medications may interact with other CNS depressants and enhance their effects on the body. If we speak about warnings for pregnant and breastfeeding women, both drugs have limited evidence to highlight any adverse reactions.[12] However, patients are advised to discuss the possibilities with their doctor before starting the prescribed treatment.

Contraindications and important interactions for Hydroxyzine Pamoate and Hydroxyzine

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Cost Comparison

How much do Hydroxyzine Pamoate and Hydroxyzine cost?

Hydroxyzine Pamoate and Hydroxyzine HCL are readily available in drug stores. However, you may need a doctor’s prescription to get these medications. Since both drugs have the same active agent, you may find them (interchangeably) under different brand names. A 25 mg capsule (oral) may cost you $0.38, while a pack of 30 capsules may cost $11.49. If you need a 50 mg capsule, you may get it for $0.26. The whole pack may cost you around $13.18.

Moreover, the average cost of treatment per day may be around $0.70 ($16.85 per prescription). Please note that the costs may vary based on the choice of brand.

Popularity of Hydroxyzine Pamoate and Hydroxyzine

Hydroxyzine Pamoate and Hydroxyzine HCL are widely popular for treating anxiety, tension, and allergic reactions in patients. The drug holds the 70th rank on the list of the top drugs, with an estimated 10,058,837 prescriptions (as of 2020) in the U.S. alone. Both drugs may vary in terms of their effectiveness in certain patients.

Conclusion

Takeaway

Hydroxyzine Pamoate and Hydroxyzine are two forms of the same drug formulation. Both drugs are prescribed to treat anxiety, tension, and allergic reactions such as itching. The primary difference between the two is their forms of availability in the market. Both drugs are affordable and hold the top 70th rank on the list of the top drugs. Additionally, several pieces of research highlight the effectiveness of the two drugs in treating the said conditions.