Drug interactions
Alprazolam + Hydroxyzine
Severity: Moderate
Alprazolam and Hydroxyzine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs are sedating and are often used for anxiety, so together they cause more drowsiness, impaired concentration and reduced coordination. Elderly patients are at particular risk of confusion and falls.
What this interaction means in plain words
Alprazolam and Hydroxyzine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Alprazolam belongs to Central Nervous System; Hydroxyzine belongs to Respiratory.
Why it happens
Additive CNS depression from GABA-A enhancement by the benzodiazepine and central H1 antagonism by hydroxyzine.
What to do
Use the lowest effective doses and avoid combining them in older adults when possible. Counsel on avoiding driving and alcohol.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Other interactions of Hydroxyzine
- Alfentanil + Hydroxyzine Major
Frequently asked questions
Can I take Alprazolam with Hydroxyzine?
MediHelp rates the interaction as moderate. Alprazolam and Hydroxyzine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both drugs are sedating and are often used for anxiety, so together they cause more drowsiness, impaired concentration and reduced coordination. Elderly patients are at particular risk of confusion and falls.
How serious is the interaction between Alprazolam and Hydroxyzine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and avoid combining them in older adults when possible. Counsel on avoiding driving and alcohol.
What other medicines interact with Alprazolam?
MediHelp also lists interactions of Alprazolam with, for example, Calcium / magnesium / potassium / sodium oxybates, Itraconazole, Ketoconazole. The full list is on the Alprazolam page.
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