Can you take hydroxyzine and melatonin together?

In this article:

• Can you take hydroxyzine and melatonin together?
• Interactions
• What medications should you not mix with hydroxyzine or melatonin?
• What sleep aids can I take with hydroxyzine or melatonin?

In this article

• Can you take hydroxyzine and melatonin together?
• Interactions
• What medications should you not mix with hydroxyzine or melatonin?
• What sleep aids can I take with hydroxyzine or melatonin?

Hydroxyzine, sold under the brand name Vistaril, is a prescription antihistamine drug that healthcare providers prescribe to treat anxiety disorders, nausea, and itching. 

Melatonin is a hormone naturally made in the body. It is not a type of medication but a dietary supplement that may help regulate sleep-wake cycles, insomnia, and circadian rhythm sleep disorders. 

While some healthcare providers say it’s safe to take them together, others heavily advise against this combination. If your healthcare provider approves taking melatonin and hydroxyzine together, it’s important to understand the side effects, potential drug interactions, and dosing schedule of this combination of medications. 

Can you take hydroxyzine and melatonin together?

According to Francis Shih, MD, a psychiatrist and medical director of Neuro Wellness Spa in Manhattan Beach, California, it is safe to take the prescription drug hydroxyzine and melatonin together, but you should consult with your healthcare provider before starting treatment. “Hydroxyzine and melatonin both cause drowsiness,” he says. “When taken together, they may cause excess sleepiness or dizziness, so dosing should be under the supervision of a physician.”

Claudia Cometa, PharmD, a pharmacist and the CEO and executive health consultant of Peace Advocacy Group of Clearwater, Florida, believes this combination should be avoided entirely. “While many people do take multiple medications to treat a single condition, such as insomnia, this practice is not widely recommended or supported by medical literature,” she says. “The additive effects of medications that affect the central nervous system, such as hydroxyzine and melatonin, can result in drowsiness, dizziness, and confusion.”

There are also instances where certain people within a certain age group or who are living with certain medical conditions should avoid mixing the antihistamine medication hydroxyzine and the supplement melatonin entirely. 

Older adults

While Dr. Cometa advises against the use of the combination of this drug and supplement, she says it’s especially unsafe for older adults. “Combinations like this should be especially avoided in the elderly population due to the high risk of falls as well as patients with glaucoma and urinary retention,” she says.

Certain health conditions

It may also be unsafe for people with certain medical conditions to use melatonin and hydroxyzine together. 

“People with lung, liver, and kidney disease should seek consultation from a physician or health care professional before taking hydroxyzine and melatonin together,” Dr. Shih says. “Breathing problems, dizziness, confusion, and falling can occur with at-risk individuals.”

Dosage

If you’re taking this drug and supplement combination, your healthcare provider can guide you on a safe dosing schedule. If hydroxyzine and melatonin can be safely taken together, Dr. Shih says that they should be started at the lowest dosages under the supervision of a healthcare provider. “Hydroxyzine starts at 10 milligrams (mg) in tablet form and lower in liquid form,” he says. “Melatonin dosages typically start at 1-2 mg.”

Ultimately, your healthcare provider can determine whether or not this drug combination is safe for you, so it’s best to consult them for any questions regarding the dosages of hydroxyzine and melatonin.

Are there benefits of taking hydroxyzine and melatonin at the same time?

If your healthcare provider deems it safe to take hydroxyzine and melatonin together, this medication and supplement combination could improve your sleep quality. “If an individual does not respond to either hydroxyzine or melatonin alone at a safe maximum dose, taking them together can be a safe alternative to stronger prescription medication for sleep,” Dr. Shih says. “Neither medication is considered addictive or habit forming.”

However, Dr. Cometa says that someone taking melatonin for sleep troubles may benefit more from taking this dietary supplement with a different antihistamine to avoid unwanted side effects. “I would recommend a second-generation antihistamine, such as cetirizine or loratadine, rather than hydroxyzine,” she says.

Hydroxyzine and melatonin interactions

With the mixed opinions on the safety and efficacy of mixing hydroxyzine and melatonin, it’s important to discuss their potential risks, including interactions and side effects. 

“[Hydroxyzine and melatonin] interactions include all sedating medications, such as opioids, anti-anxiety medications, and additional antihistamines and insomnia medications,” says Dr. Cometa. “Hydroxyzine should not be used in patients with cardiac conditions or elderly patients. In addition, poor kidney function could affect an individual’s ability to excrete, or get rid of, the medication and prolong its effects.”

In regards to melatonin interactions, Dr. Shih says the dietary supplements can interact with alcohol, sedatives, opioids, antihistamines, antihistamines, anticoagulants, contraceptives, and psychiatric medications. “Melatonin should also be avoided during pregnancy, while breastfeeding, or if you have epilepsy or liver disease,” he says. 

In addition to their possible interactions, hydroxyzine and melatonin have their own individual side effects.

According to Dr. Shih, potential side effects of hydroxyzine include:

• Drowsiness
• Dry mouth
• Dizziness
• Confusion
• Blurred vision
• Headache
• Constipation
• Difficulty urinating 

Rare severe side effects of hydroxyzine include:

• Allergic reaction (difficulty breathing, hives, swelling of your lips, tongue, or face)
•  Unsafe heart rhythm
• Hallucinations
• Priapism (an erection that does not go away after four hours)
• Acute generalized exanthematous pustulosis (AGEP), a type of skin rash
• Serotonin syndrome (a life-threatening drug reaction that occurs from having too much serotonin in your body)

Additionally, Dr. Shih lists the following as possible adverse effects of the supplement melatonin:

• Drowsiness
• Dizziness
• Headaches
• Nausea
• Mood changes
• Changes in sleep patterns

If you’re experiencing any interactions or serious side effects, please reach out to your healthcare provider as soon as possible for medical care. 

How long after taking hydroxyzine can you take melatonin? 

There are no specific or preferred dosing guidelines for taking melatonin and hydroxyzine. To get safe dosage or dosing scheduling guidance for these treatments, Dr. Shih recommends speaking with your healthcare provider for medical advice and additional information.

What medications should you not mix with hydroxyzine or melatonin? 

As previously mentioned, certain medications should never be taken with hydroxyzine or melatonin. According to Dr. Cometa, these include additional sedative medications, such as opioids, anti-anxiety medications, additional antihistamines, and additional insomnia medications.

What sleep aids can I take with hydroxyzine or melatonin?

According to Dr. Cometa, it’s difficult to determine which sleep aids are safe to take with hydroxyzine or melatonin. “There are very few classes of medications that are recommended by the American Academy of Sleep Medicine due to the side effect profile of most sedating medications,” she says. “Therefore, caution must be exercised in choosing to take more than one sleep aid at a time.”

When it comes to taking hydroxyzine and melatonin, healthcare providers have mixed opinions on whether they’re safe together. That said, it’s important to be aware of the potential risks and contact your healthcare provider if you have any questions or concerns about the combination. “Hydroxyzine and melatonin are generally considered safer alternatives to prescription sleep aids, but they still have risks,” Dr. Shih says. “Consultation with a healthcare provider is advised.”