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Hydroxyzine vs. Benadryl—What Will Work for You?

Hydroxyzine vs. Benadryl—What Will Work for You?

You’re lying awake, with the tick-tock of the clock echoing in the silence, a stark reminder of the sleep that eludes you. It’s a scenario all too familiar to many—a recent survey shows that about 39% of adults in the U.S. had experienced sleep problems in the past 12 months.

When insomnia strikes, the search for an effective solution becomes paramount. With many available options, opting for the right one is a challenging trial-and-error cycle. When it comes to medications, hydroxyzine and Benadryl proved to be viable choices for overcoming sleeplessness. Check out how they work in this comprehensive hydroxyzine vs. Benadryl comparison to make the right choice.

Hydroxyzine and Benadryl—An Overview

Hydroxyzine and Benadryl are both antihistamines—a class of drugs that block the actions of histamine in the body to reduce the symptoms of allergies. Despite being in the same class, they have different uses and effects.

Hydroxyzine, sold under brand names Atarax and Vistaril, is primarily prescribed as an antihistamine to treat itching, allergies, and skin rash. It’s also used to treat sleeplessness and anxiety.

Meanwhile, Benadryl (diphenhydramine) is commonly used to relieve symptoms of allergies, such as sneezing, a runny nose, and itchy or watery eyes. It also prevents and treats nausea, vomiting, and dizziness caused by motion sickness. It can be prescribed as a sleep aid but typically only for short-term sleeping problems and mild disturbances.

While hydroxyzine is a prescription-only medication, Benadryl is available over the counter. Both drugs are FDA-approved but not for insomnia, so their use in treating sleep issues is off-label.

Benadryl and Hydroxyzine—Key Facts

You can check out a side-by-side comparison of hydroxyzine and Benadryl in the following table:

Characteristics

Hydroxyzine

Benadryl

Active component

Hydroxyzine

Diphenhydramine HCl

Drug classification

Antihistamine, miscellaneous anxiolytic, sedative, and hypnotic

First-generation antihistamine

FDA-approved

Yes

Yes

Drug form

Tablets, capsules, injectable liquid

Tablets, liquid-filled capsules, liquid solution, topical (cream, gel, spray, stick)

Average dose

10–50 mg per day

25–50 mg every 4–6 hours

Maximum dose

400 mg per day (depending on the condition and patient)

300 mg per day

Suitable for children

Yes (only for FDA-approved conditions. Don’t give it to a child for treating insomnia without consulting your healthcare provider)

Yes, for patients aged 12 and older (don’t use it for treating children’s insomnia without consulting your healthcare provider)

Suitable for pregnant women

No

Yes, but only if approved by your healthcare provider

Prescription required

Yes

No

Hydroxyzine vs. Benadryl for Sleep—Dosage and Administration

Hydroxyzine is available in four doses:

  1. 10 mg
  2. 25 mg
  3. 50 mg
  4. 100 mg

The typical hydroxyzine dosage for adults with insomnia is 50 mg daily, taken at least 30 minutes before bedtime. Your healthcare provider will recommend the appropriate dosage based on your condition.

Meanwhile, Benadryl has two doses—25 mg and 50 mg. The average dose of Benadryl for sleep issues is 50 mg daily, taken orally. If you have mild sleep disturbances, your doctor may prescribe a lower dose of 25 mg.

You should take Benadryl 30 minutes before bedtime to allow the drug sufficient time to kick in. 

Duration of Effect

Source: Ketut Subiyanto

Whether you take hydroxyzine or Benadryl, allocate at least seven hours for sleep to allow the drug to take full effect and let the sedative effects wear off naturally. If you feel groggy after waking up, avoid performing tasks that require sharp focus, such as driving or operating heavy machinery.

While hydroxyzine and Benadryl can be effective in helping you fall asleep, they’re not designed for long-term use. With continued usage, your body can build a tolerance to these medications, reducing their effectiveness.

Hydroxyzine vs. Benadryl—Which One Should You Choose?

Choosing the most effective treatment for sleep issues depends on various factors, including your health status, medical history, and insomnia type. Hydroxyzine has more prominent sedating properties, so it’s often preferred for addressing sleep problems. Still, the ideal treatment is a nuanced decision best made by a healthcare professional.

The best treatment for insomnia combines efficient drugs with cognitive behavioral therapy for insomnia (CBT-I) and can only be designed by a sleep specialist. Unfortunately, only 1% of doctors in the U.S. are trained in sleep medicine, so seeing one can be complicated and time-consuming.

The good news is that Kick offers a groundbreaking sleep program that combines science-based methods with personalized treatment plans that fit your lifestyle and health status. As a cutting-edge telemedicine platform, it lets you visit a sleep expert almost immediately.

Enjoy Restful Nights With Kick’s Groundbreaking Sleep Program

Source: EKATERINA BOLOVTSOVA

Kick is a game-changer in your quest for better sleep, with a unique approach tailored to your case. We provide off-label sleep medications like trazodone, hydroxyzine, and gabapentin, selected thoughtfully by our medical experts to match your needs and current health status.

Our team also uses the best practices of cognitive behavioral therapy for insomnia (CBT-I) to help you adopt healthy sleeping habits and reach a long-term solution for restless nights.

How Kick Works

Designed by a Stanford sleep specialist, Dr. Alex Dimitriu, Kick’s sleep program is easy to join:

  1. Visit our signup page to start your 15-minute sleep visit
  2. Fill out the medical intake form to help us understand your sleep issues
  3. Choose between pharmacy pickup and home delivery for your medication
  4. Provide shipping and payment details

Our sleep specialists will review your information and handpick two trial medications that suit you best, reducing the risk of dependence while ensuring effective treatment. Your doctor will check in with you every month, offer tips on CBT-I best practices, and adjust your dosage if necessary to help you get a good night’s sleep quickly.

If our sleep specialists decide our program isn’t the best solution for you, they’ll refer you to your primary healthcare provider, and you won’t have to pay for your initial consultation thanks to our Doctor Guarantee.

An accolade of positive reviews on Trustpilot is a testament to our commitment to our patients and the exceptional results we achieved working together. Join Kick today to begin the journey of reclaiming restful nights.

Hydroxyzine vs. Benadryl—Potential Side Effects

Hydroxyzine and Benadryl can have similar side effects that are typically mild, including:

  1. Drowsiness
  2. Dizziness
  3. Headache

Rare adverse reactions to these drugs are:

  • Confusion in the elderly
  • Dry mouth or nose
  • Low blood pressure
  • Blurry vision
  • Constipation

Severe hydroxyzine side effects may include seizures, chest pain, increased heart rate, painful or insufficient urination, and unintentional muscle movements.

Severe adverse reactions to Bendaryl include confusion, difficulty breathing, a swollen face, and uncontrollable movements.

This list isn’t exhaustive—always consult your healthcare professional for comprehensive medication information. If you experience adverse reactions, inform your doctor so they can advise you on the best ways to mitigate the side effects or prescribe an alternative treatment.

Hydroxyzine vs. Benadryl for Sleep—Who Should and Shouldn’t Use These Drugs?

Source: Eren Li

Hydroxyzine and Benadryl can help adults grappling with occasional sleeplessness, which includes sleep onset and sleep maintenance problems. Elderly individuals can also use these medications at lower doses, but they should inform their healthcare providers if they have pre-existing medical conditions that may make the side effects more frequent.

Pregnant women can use Benadryl after consulting their healthcare providers, but they should avoid hydroxyzine because it carries potential risk of birth defects. Breastfeeding women should avoid both drugs since they can pass through breast milk and increase the risk of adverse reactions in children.

Who Shouldn’t Use Hydroxyzine?

People with the following conditions shouldn’t use hydroxyzine:

  • Glaucoma
  • Heart disease
  • Epilepsy or a history of seizures
  • Long QT syndrome
  • Electrolyte imbalance
  • Allergies to cetirizine and levocetirizine
  • Bowel, stomach, or bladder obstructions
  • Women planning to get pregnant 

This list may not cover all conditions—ensure you provide your complete medical history to your doctor. They’ll evaluate the risks of using the medication and recommend the safest and most effective option for you. 

Long-term use of antihistamines has been linked to certain health risks. For instance, a study found that long-term use of anticholinergics, which include Benadryl and hydroxyzine, was associated with an increased risk of dementia.

Inform your healthcare provider if you’ve had sleep problems for a long time. If you need long-term treatment, they may recommend Quviviq and other drugs appropriate for individuals with chronic sleeplessness.

Who Shouldn’t Use Benadryl?

Individuals with the following conditions shouldn’t use Benadryl:

  • Glaucoma
  • Heart disease
  • Low blood pressure
  • Bowel, stomach, or bladder obstructions
  • Liver or kidney diseases
  • Allergy to diphenhydramine
  • Asthma or breathing disorders

This list isn’t comprehensive. Your doctor may recommend alternatives to this medication if your risk of severe adverse reactions is high.

Hydroxyzine vs. Benadryl—Interactions With Other Substances

Source: Ron Lach

Hydroxyzine and Benadryl can interact with other drugs, increasing the risk of side effects or reducing the potency of the drugs. You can find a detailed breakdown of the interactions between hydroxyzine and Benadryl and other substances in the table below:

Substance

Interaction With Hydroxyzine

Interaction With Benadryl

Opioids and CNS depressants 

Can contribute to the sedative effects, increasing risks of drowsiness and accidental falls

Can contribute to the side effects of opioids and CNS depressants, leading to increased sedation 

Heart medications 

Can interact with heart medications, affecting heart rhythm

Can interact with certain heart medications, causing drowsiness and other side effects

Blood pressure medication

Can interact with blood pressure medications, causing irregular heart rhythms

Unlikely to raise blood pressure. When taken with blood pressure medications (such as propranolol or metoprolol), it may cause your blood pressure to dip too low

Anti-seizure medication

Can increase the risk of side effects like dizziness, confusion, and drowsiness

Most anti-seizure medicines interact with each other and other drugs. Avoid Benadryl when taking anti-seizure medications

Anti-HIV drugs

The potential for interaction is low but hasn’t been ruled out

Generally safe to take with most HIV drugs

Infection medications

Can interact with some antibiotics, changing heart rhythm

Generally safe to take with most antibiotics

Sleep or anxiety medications

Can increase the sedative effects, causing dizziness and headaches

Can interact with sleep or anxiety medications, causing increased sedation

Muscle relaxants

Can increase the sedative effects 

Taking Benadryl with muscle relaxants can cause increased sedation

Antihistamines

Can increase the risk of side effects like drowsiness and dizziness

Increased risks of side effects, such as dizziness and constipation

Herbal supplements

Can increase the risk of side effects like drowsiness, confusion, and dizziness

Not enough information to claim that herbal remedies and supplements are safe to take with Benadryl

Alcohol

Can intensify the risk of drowsiness and headaches

Can intensify the risk of drowsiness and headaches

Inform your healthcare provider about any medications or supplements you’re taking. They’ll assess the risk of interactions and recommend ways to minimize the potential side effects of taking hydroxyzine or Benadryl alongside other drugs.

Hydroxyzine and Benadryl for Sleep—What Are the Alternatives?

For those at higher risk of adverse reactions to hydroxyzine and Benadryl or in need of more potent sleep treatments, healthcare providers may suggest the following alternatives:

Still, these options may not offer a definitive solution for long-term sleep issues. For a more comprehensive approach, consider Kick’s sleep program.

Featured image source: Andrea Piacquadio