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Can You Mix Hydroxyzine & Methadone?

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Aug 11, 2023 • 3 cited sources

Hydroxyzine and methadone are sometimes prescribed together, but mixing these medications carries some risks. You should never mix them without first discussing it with your doctor and talking about the associated risks and potential alternative treatments that may meet your needs.

Dangers & Risks of Mixing Hydroxyzine & Methadone

Methadone is a treatment for opioid use disorder (OUD). Hydroxyzine is an antihistamine medication that is used for several indications, including allergies, insomnia, and sometimes off-label for anxiety.

Mixing hydroxyzine and methadone is possible and usually safe. The main risk is that both medications have the potential to cause drowsiness and increase respiratory depression. Therefore, taking these medications should be done under the supervision of a physician.

In very rare occasions, taking these medications together can cause a person’s heart rate to become irregular, which can be fatal in rare cases. This danger is especially significant for people who are already at risk for heart complications or who are on high doses of methadone.[1]

Alternative Treatment Options

Hydroxyzine is an antihistamine that may be used to treat anxiety, sleep problems, nausea, vomiting, itching, skin rash, and allergies. Meanwhile, methadone is an opioid that can be used as part of Medication for Addiction Treatment for opioid use disorder (OUD).[2]

If you or your doctor have concerns about using Hydroxyzine while on methadone, other alternatives exist, depending on the reason you are using hydroxyzine.

For example, if you are using hydroxyzine for allergies, there are other similar allergy medications that tend to cause less sedation, such as Loratidine.

If you are using Hydroxyzine for sleep or anxiety, there are other medications that are likely safer and less likely to cause sedation and/or respiratory depression in a patient on Methadone. 

When to Consult a Doctor 

If you need to take Hydroxyzine while on Methadone, it may be very safe, but should be discussed first with your doctor. Talk openly with your doctor about any medications you are taking while on Methadone. If you experience any serious symptoms associated with the heart while on hydroxyzine and methadone such as palpitations or chest pain, call your doctor immediately.

In conclusion, it may be appropriate or necessary for you to take Methadone and Hydroxyzine simultaneously. The main risks are over-sedation or drowsiness. Talk to your doctor before taking these medications together.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where ... Read More

  1. Hydroxyzine (Vistaril, Atarax). National Alliance on Mental Illness. September 2021. Accessed August 2022.
  2. Methadone Treatment of Opiate Addiction: A Systematic Review of Comparative Studies. Innovations in Clinical Neuroscience. July–August 2017). Accessed August 2022.
  3. Buprenorphine Treatment for Opioid Use Disorder: An Overview. CNS Drugs. June 2019. Accessed August 2022.

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