NutriStack
Alcohol and Hydroxyzine, a caution.
Alcohol can markedly worsen hydroxyzine-related drowsiness, slowed reaction time, and clumsiness. In a controlled crossover trial, hydroxyzine taken with alcohol produced the greatest and most persistent psychomotor impairment among tested antihistamine-alcohol combinations. Risk is higher with higher hydroxyzine doses, older age, sleep apnea, lung disease, or other CNS depressants.
One pair, every claim cited. The two substances, the type, the mechanism, the recommendation, and the primary literature.
Same shape as the other 1,729 pairs in the public database.
From the interaction database
What the row says.
Every entry follows the same shape: what is happening, the mechanism, the recommendation, and the primary literature.
At a glance
- Substances
- Alcohol and Hydroxyzine
- Pair type
- Caution
- Evidence (highest tier)
- Strong
- Source citations
- 2 sources
- Stack Score effect
- −5 to your Stack Score (per scored caution row).
- Scope
- Supplement × Prescription
- Last verified
- May 30, 2026
Caution · Strong evidence
Caution
What is happening. Alcohol can markedly worsen hydroxyzine-related drowsiness, slowed reaction time, and clumsiness. In a controlled crossover trial, hydroxyzine taken with alcohol produced the greatest and most persistent psychomotor impairment among tested antihistamine-alcohol combinations. Risk is higher with higher hydroxyzine doses, older age, sleep apnea, lung disease, or other CNS depressants.
Mechanism. Hydroxyzine is a brain-penetrant H1 antihistamine with sedative properties from central H1 blockade and suppression of subcortical arousal pathways. Alcohol adds CNS depression and psychomotor slowing, producing pharmacodynamic impairment that spacing doses does not reliably prevent.
Recommendation. Do not drink alcohol when taking hydroxyzine for allergy, itching, anxiety, or sleep. If you already drank, avoid non-urgent hydroxyzine dosing and do not drive until fully alert. Seek urgent help for severe sleepiness, fainting, confusion, or slow breathing.
Sources (2)
- García-Gea C, Martínez J, Ballester MR, Gich I, Valiente R, Antonijoan RM. Psychomotor and subjective effects of bilastine, hydroxyzine, and cetirizine, in combination with alcohol: a randomized, double-blind, crossover, and positive-controlled and placebo-controlled Phase I clinical trials. Hum Psychopharmacol. 2014;29(2):120-132. PMID 24395298
- Conen S, Theunissen EL, Vermeeren A, Ramaekers JG. Short-term effects of morning versus evening dose of hydroxyzine 50 mg on cognition in healthy volunteers. J Clin Psychopharmacol. 2011;31(3):294-301. PMID 21508863
Stack Score
How this pair moves the number.
Effect on the composite score
If both Alcohol and Hydroxyzine are in the same stack, this pair applies −5 to your Stack Score (per scored caution row).
The full algorithm, the clamping rules, and four worked stacks are documented at /methodology/stack-score.
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