Vistaril vs Xanax For Anxiety – Differences & Side Effects


It is the brand name of a drug called hydroxyzine, that belongs to a group of drugs called antihistamines.

Mechanism of Action

This medication works by blocking a particular natural substance which the human body produces during an allergic reaction.

Note – although classified as a histamine blocker, this medication also possesses antiemetic, antispasmodic, sedative, and anticholinergic properties.

It is produced by Pfizer, an American pharmaceutical conglomerate with the headquarters in New York City.


This medication is used to:

  • to control vomiting and nausea (except in pregnancy);
  • induce sedation prior to or after anesthesia;
  • as part of the treatment of alcoholism;
  • relieve itching (pruritus) caused by various allergic conditions;
  • treat tension and anxiety.

Drug Interactions

This antihistamine may negatively interact with other drugs, especially with:

  • meperidine (Demerol);
  • sleeping pills, sedatives, and tranquilizers;
  • drugs for mental illness, like –  clozapine (Fazaclo ODT, quetiapine (Seroquel), iloperidone (Fanapt), and ziprasidone (Geodon);
  • drugs for seizures;
  • clarithromycin (Biaxin);
  • allopurinol;
  • pentamidine (Pentam, Nebupent);
  • barbiturates (a drug which acts as a central nervous system depressant);
  • ondansetron (Zuplenz, Zofran);
  • drugs for arrhythmias (a group of conditions in which the heartbeat is irregular, too slow, or too fast), like – procainamide, amiodarone (Nexterone), sotalol (Sorine, Betapace), and quinidine (Nuedexta);
  • droperidol (Inapsine);
  • drugs for pain;
  • moxifloxacin (Avelox);
  • antidepressants, like – fluoxetine (Sarafem, Prozac, Selfemra) and citalopram (Celexa);
  • methadone (Methadose);
  • drugs for anxiety;
  • abreva;
  • erythromycin (PCE);
  • gatifloxacin (an antibiotic of the fourth-generation fluoroquinolone family).


This antihistamine is taken up to 4 times a day. It comes in injectable, capsule, tablet, intramuscular and syrup forms.


To make sure that this antihistamine is safe for you, tell your healthcare provider if you have:

  • bladder obstruction;
  • slow heartbeats;
  • glaucoma;
  • blockage in your intestines or stomach;
  • heart disease;
  • if you have had a heart attack;
  • personal history of long QT syndrome (a disorder of the heart’s conduction system);
  • an electrolyte imbalance.

Side Effects And Precautions

Common side effects may include:

  • sedation;
  • thickening or drying of oral and other respiratory secretions;
  • tiredness;
  • dizziness;
  • stomach distress;
  • sleepiness;
  • disturbed coordination.

Less common side effects may include:

  • nervousness;
  • nausea;
  • double vision;
  • confusion;
  • irritability;
  • seizure;
  • blurred vision;
  • dry mouth;
  • tremor;
  • loss of appetite.


Do not drink alcohol while taking this medication since alcohol can worsen the side effects of this medication.


Pregnancy & Breastfeeding

According to studies, the use of this antihistamine during the first months of pregnancy may cause birth defects.

It is not recommended to use this antihistamine if you are breastfeeding a baby since small amounts of it may pass into the breast milk and may negatively affect your baby.


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It is the brand name of a drug called alprazolam, that belongs to a class of drugs called benzodiazepines. This benzodiazepine is the single most prescribed psychiatric medication in the United States.

This medication is manufactured by Pfizer, an American pharmaceutical corporation. It was first approved by the US Food and Drug Administration in 1981.


This prescription medication is used to treat panic disorder and anxiety disorders.


The usual recommended dose is 0.25 to 0.5 mg given three times per day. The maximum recommended daily dosage is 4 mg.

It acts quickly in the body with most of the effects occurring within the first hour of use. This drug has a half-life of 12.15 hours and an M/P ratio of 0.4.

It is available in various forms, including as an extended-release tablet, liquid, tablets, and disintegrating tablets.

Mechanism of Action

This medication acts on the nerves and brain in order to produce a calming effect by enhancing the effects of gamma-Aminobutyric acid. It is metabolized by CYP3A4 (an important enzyme in the body), that fluvoxamine inhibits.


This benzodiazepine may be habit-forming and its use may lead to addiction, overdose, or death. Abuse can become an addiction when you:

  • cannot stop taking this medication;
  • continue to take the drug despite negative consequences;
  • take this benzodiazepine for recreational purposes or non-medical;
  • begin to crave for this drug.

Drug Interactions

It may negatively interact with other medications, especially:

  • sleep medications, like – Unisom or Zolpimist;
  • antihistamines;
  • Adalat or Procardia (nifedipine);
  • ergotamines, such as – Cafergot;
  • antifungal drugs, such as – Sporanox or Nizoral;
  • other antifungals, like – Diflucan (fluconazole) and Vfend;
  • other benzodiazepines, like – Versed, Restoril, or Serax;
  • certain medications which decrease stomach acid;
  • Gengraf or Sandimmune (cyclosporine);
  • Lunesta;
  • Cortastat, Solurex, or DexPak (dexamethasone);
  • Dilacor or Tiazac (diltiazem);
  • HIV and AIDS medicine, like – Reyataz, Invirase, or Kaletra;
  • antibiotics, like – Biaxin, Priftin, and Ketek;
  • antidepressants, like – Asendin, Prozac, or Zoloft;
  • Theo-24 or Uniphyl (theophylline);
  • antiseizure medications, like – Carbatrol or Mysoline;
  • sedating allergy medications, like – Benadryl or Atarax;
  • antipsychotics, like – Saphris, Abilify, or Latuda;
  • anesthetics;
  • conivaptan;
  • Cordarone or Pacerone (amiodarone);
  • birth control pills;
  • barbiturates, like – Amytal or Solfoton;
  • narcotic medication, like – Lortab, Stadol, or Darvocet.

Pregnancy & Breastfeeding

This benzodiazepine is not safe to use while breastfeeding because taking it while nursing can cause harmful side effects to the nursing infant.

It may cause birth defects, especially if taken during the first trimester of pregnancy.

Side Effects And Precautions

Common side effects may include:

  • lack of appetite;
  • problems sleeping;
  • unusual tiredness;
  • being forgetful;
  • drowsiness;
  • clumsiness.

Less common side effects may include:

  • problems performing routine tasks;
  • loss of pleasure;
  • feeling sad;
  • slurred speech;
  • unsteadiness;
  • a difficulty with coordination;
  • lightheadedness;
  • problems concentrating;
  • irritability;
  • unsteady walk;
  • discouragement;
  • changes in rhythms of speech.


Do not drink alcohol while taking this benzodiazepine since alcohol can worsen the side effects of this medication.

Bottom Line – Vistaril vs Xanax

Vistaril (active ingredient – hydroxyzine) is an antihistamine medication that is used to treat itching caused by allergies. The absorption of this antihistamine through the gastrointestinal tract occurs in 15 to 30 minutes with peak levels at 2 hours. It works by blocking the actions of one of the body’s natural chemicals, called histamine.

Xanax (active ingredient – alprazolam) is a medication that works by increasing the amount of GABA, a neurotransmitter which promotes a relaxed feeling and calmness. This drug is highly addicting and it can and is habit-forming. It reaches peak plasma levels within 1 to 2 hours and has a half-life of 12 to 15 hours.

According to a 1993 study, both medications are safe and efficient oral premedicants. But, Xanax is preferable to Vistaril in terms of anxiolytic and adverse effects.

Regarding their price, the average retail price for 15 tablets of Xanax 0.5mg is $77, while the average retail price for 15 capsules of Vistaril 25mg is $40.



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