Hydroxyzine side effects: what 47,369 FDA adverse event reports show
Drug class
Not stated in label
Brand names
Hydroxyzine Hydrochloride
Who reports
47,369 reports · 66% serious · 6,790 with death outcome · 66% female
Used for
For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested. Useful in the management of pruritus due to allergic conditions such as chronic urticaria and atopic and contact dermatoses and in histamine-mediated pruritus.
What it is
DESCRIPTION Hydroxyzine hydrochloride, USP has the chemical name of 2-[2-[4-(p-Chloro-α-phenylbenzyl)-1-piperazinyl]ethoxy] ethanol dihydrochloride. C 21 H 27 ClN 2 0 2 •2HCI M.W. 447.83 Hydroxyzine hydrochloride, USP occurs as a white, odorless powder which is very soluble in water.
Boxed warning
None in the current label
Causality screen of the 40 strongest signals
What the badges mean
- Labeled (related wording) The label describes this effect under different wording (e.g. 'neutropenia' for 'neutrophil count decreased'). Treated as known.
- Likely indication confounding The term appears in the label's indications: reports probably describe the disease being treated (or its progression), not a drug effect. Classic confounding by indication.
- Reporting / coding artifact An administrative, monitoring or exposure term (product issue, off-label use, 'test normal', overdose...). Not a biological reaction; a high PRR here reflects how reports are coded.
- Lab value / disease marker A laboratory result, investigation or disease-activity marker (antibody positive, CRP abnormal, swollen joint count) not described in the label. These usually mirror the monitored disease or testing protocol rather than a drug effect; not screened further.
- Outcome field, not a reaction Death is a report outcome, not a reaction term. It is dominated by the underlying illness; see the seriousness profile and the boxed warning instead.
- Not in label — unassessed Not found in the label text, not an artifact pattern. This is a genuine candidate for a formal causality assessment (Bradford Hill / WHO-UMC); it has NOT had one here.
Strongest disproportionality signals
Flagged terms (PRR ≥ 2, χ² ≥ 4, n ≥ 10), ranked by PRR; infinite PRRs (no comparator reports) excluded. The EBGM column is a second, shrinkage-based estimate (MGPS) with its 5th percentile EB05 and the BCPNN IC025; a pair flagged by PRR alone is marked PRR-only and should be read as fragile. The strata column recomputes the PRR on serious reports only (and, for the 300 most-reported drugs, adjusted for age band), and flags pairs whose reports are unusually skewed by sex or come mostly from consumers. Each row also shows the PRR against the other drugs of the same FDA class, which removes most confounding by the condition being treated, and a calibrated p-value: on validation, known non-causes average an ROR of about 2, so significance is judged against that empirical null (✓ = p < 0.05 after calibration). 1,133 further terms are in the interactive explorer. Reaction links open the term's cross-drug page.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Urticaria thermal | 42 | 182.9 127.6–262.2ROR 183.1 · calibrated p 3e-9 ✓ | 122.1 EB05 94.1 · IC025 +5.2 3/3 methods agree | Likely indication confounding shares a disease stem with the indications wording | serious n=42 · ♀ 100% (drug 66%) | no trial arm names this drug |
| Chemical submission | 46 | 101.2 73.4–139.4ROR 101.3 · calibrated p 2e-7 ✓ | 79.7 EB05 62.1 · IC025 +5.0 3/3 methods agree | Not in label — unassessed | serious n=46 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Neuroblastoma recurrent | 37 | 99.5 69.6–142.1ROR 99.5 · calibrated p 3e-7 ✓ | 78.0 EB05 59.1 · IC025 +4.7 3/3 methods agree | Not in label — unassessed | serious n=37 · ♀ 0% (drug 66%) · 100% clinician | no trial arm names this drug |
| Persistent genital arousal disorder | 34 | 75.5 52.5–108.7ROR 75.6 · calibrated p 2e-6 ✓ | 62.4 EB05 46.7 · IC025 +4.5 3/3 methods agree | Not in label — unassessed | serious n=34 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Chronic spontaneous urticaria | 102 | 45.0 36.7–55.2ROR 45.1 · calibrated p 3e-5 ✓ | 40.6 EB05 34.4 · IC025 +4.8 3/3 methods agree | Likely indication confounding shares a disease stem with the indications wording | serious n=98 | no trial arm names this drug |
| Peripheral circulatory failure | 34 | 40.0 28.2–56.8ROR 40.0 · calibrated p 8e-5 ✓ | 36.1 EB05 27.0 · IC025 +4.0 3/3 methods agree | Not in label — unassessed | serious n=34 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Multiple drug therapy | 57 | 39.3 30.0–51.5ROR 39.3 · calibrated p 8e-5 ✓ | 35.7 EB05 28.6 · IC025 +4.4 3/3 methods agree | Reporting / coding artifact | serious n=56 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Victim of chemical submission | 38 | 30.6 22.0–42.5ROR 30.6 · calibrated p 3e-4 ✓ | 28.3 EB05 21.5 · IC025 +3.9 3/3 methods agree | Not in label — unassessed | serious n=38 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Anticholinergic syndrome | 93 | 27.4 22.2–33.7ROR 27.4 · calibrated p 5e-4 ✓ | 25.7 EB05 21.6 · IC025 +4.2 3/3 methods agree | Labeled (related wording) related wording | serious n=92 · 100% clinician | no trial arm names this drug |
| Suspected suicide | 250 | 24.4 21.5–27.7ROR 24.6 · calibrated p 8e-4 ✓ | 23.2 EB05 20.8 · IC025 +4.3 3/3 methods agree | Not in label — unassessed | serious n=250 · 100% clinician | no trial arm names this drug |
| Bacterial disease carrier | 38 | 24.3 17.5–33.7ROR 24.3 · calibrated p 0.001 ✓ | 22.8 EB05 17.4 · IC025 +3.6 3/3 methods agree | Reporting / coding artifact | serious n=36 · ♀ 100% (drug 66%) | no trial arm names this drug |
| Bronchial wall thickening | 35 | 22.4 15.9–31.4ROR 22.4 · calibrated p 0.002 ✓ | 21.1 EB05 15.8 · IC025 +3.5 3/3 methods agree | Not in label — unassessed | serious n=35 · ♀ 100% (drug 66%) | no trial arm names this drug |
| Chronic kidney disease-mineral and bone disorder | 48 | 20.6 15.4–27.5ROR 20.6 · calibrated p 0.002 ✓ | 19.6 EB05 15.3 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | serious n=48 | no trial arm names this drug |
| Victim of crime | 52 | 20.3 15.4–26.8ROR 20.3 · calibrated p 0.002 ✓ | 19.3 EB05 15.3 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | serious n=52 · 100% clinician | no trial arm names this drug |
| Dry age-related macular degeneration | 43 | 17.8 13.1–24.2ROR 17.8 · calibrated p 0.004 ✓ | 17.0 EB05 13.1 · IC025 +3.3 3/3 methods agree | Not in label — unassessed | serious n=43 · ♀ 100% (drug 66%) | no trial arm names this drug |
| Bone demineralisation | 39 | 16.8 12.2–23.2ROR 16.8 · calibrated p 0.005 ✓ | 16.1 EB05 12.2 · IC025 +3.2 3/3 methods agree | Not in label — unassessed | serious n=35 · ♀ 0% (drug 66%) | no trial arm names this drug |
| Distributive shock | 81 | 16.8 13.5–21.0ROR 16.8 · calibrated p 0.005 ✓ | 16.1 EB05 13.4 · IC025 +3.5 3/3 methods agree | Not in label — unassessed | serious n=81 · 100% clinician | no trial arm names this drug |
| Mast cell activation syndrome | 47 | 16.2 12.1–21.7ROR 16.3 · calibrated p 0.006 ✓ | 15.5 EB05 12.1 · IC025 +3.3 3/3 methods agree | Not in label — unassessed | serious n=44 · ♀ 100% (drug 66%) · 100% consumer | no trial arm names this drug |
| Nephrogenic anaemia | 161 | 15.7 13.5–18.4ROR 15.8 · calibrated p 0.006 ✓ | 15.2 EB05 13.3 · IC025 +3.6 3/3 methods agree | Not in label — unassessed | serious n=161 | no trial arm names this drug |
| Hyperparathyroidism secondary | 85 | 15.3 12.4–19.0ROR 15.4 · calibrated p 0.007 ✓ | 14.8 EB05 12.3 · IC025 +3.4 3/3 methods agree | Not in label — unassessed | serious n=85 | no trial arm names this drug |
| Infusion site discharge | 57 | 15.2 11.7–19.8ROR 15.2 · calibrated p 0.007 ✓ | 14.6 EB05 11.6 · IC025 +3.3 3/3 methods agree | Not in label — unassessed | serious n=40 · ♀ 100% (drug 66%) · 100% consumer | no trial arm names this drug |
| Bronchial secretion retention | 40 | 14.4 10.5–19.8ROR 14.4 · calibrated p 0.010 ✓ | 13.7 EB05 10.4 · IC025 +3.1 3/3 methods agree | Not in label — unassessed | serious n=39 · ♀ 100% (drug 66%) | no trial arm names this drug |
| Rebound acid hypersecretion | 94 | 14.0 11.4–17.1ROR 14.0 · calibrated p 0.010 ✓ | 13.5 EB05 11.3 · IC025 +3.3 3/3 methods agree | Not in label — unassessed | serious n=94 | no trial arm names this drug |
| Completed suicide (death by suicide) | 2,239 | 12.1 11.6–12.6ROR 12.6 · calibrated p 0.014 ✓ | 11.8 EB05 11.4 · IC025 +3.5 3/3 methods agree | Outcome field, not a reaction | serious PRR 10.3 · 99% clinician | no trial arm names this drug |
| Priapism | 88 | 11.5 9.3–14.2ROR 11.5 · calibrated p 0.021 ✓ | 11.0 EB05 9.2 · IC025 +3.1 3/3 methods agree | Not in label — unassessed | serious n=86 · ♀ 0% (drug 66%) · 100% clinician | no trial arm names this drug |
| Accidental death | 45 | 11.0 8.2–14.8ROR 11.0 · calibrated p 0.026 ✓ | 10.3 EB05 7.9 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious n=45 · ♀ 0% (drug 66%) · 100% clinician | no trial arm names this drug |
| Exposure via ingestion | 60 | 10.6 8.2–13.7ROR 10.6 · calibrated p 0.028 ✓ | 10.1 EB05 8.0 · IC025 +2.8 3/3 methods agree | Reporting / coding artifact | serious n=60 · 100% clinician | no trial arm names this drug |
| Vasoplegia syndrome | 36 | 10.1 7.2–14.0ROR 10.1 · calibrated p 0.036 ✓ | 9.3 EB05 6.9 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | serious n=36 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Maculopathy | 76 | 9.6 7.6–12.0ROR 9.6 · calibrated p 0.039 ✓ | 9.1 EB05 7.5 · IC025 +2.8 3/3 methods agree | Not in label — unassessed | serious n=75 · ♀ 100% (drug 66%) | no trial arm names this drug |
| Gastric polyps | 47 | 9.4 7.0–12.5ROR 9.4 · calibrated p 0.044 ✓ | 8.7 EB05 6.7 · IC025 +2.6 3/3 methods agree | Not in label — unassessed | serious n=47 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Poisoning | 259 | 9.2 8.2–10.5ROR 9.3 · calibrated p 0.042 ✓ | 9.0 EB05 8.1 · IC025 +3.0 3/3 methods agree | Not in label — unassessed | serious PRR 8.1 · 100% clinician | no trial arm names this drug |
| Blood cholesterol decreased | 37 | 8.9 6.5–12.4ROR 9.0 · calibrated p 0.052 | 8.2 EB05 6.1 · IC025 +2.4 3/3 methods agree | Lab value / disease marker | serious n=37 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Sleep disorder due to a general medical condition | 316 | 8.8 7.9–9.8ROR 8.8 · calibrated p 0.049 ✓ | 8.6 EB05 7.8 · IC025 +2.9 3/3 methods agree | Not in label — unassessed | serious PRR 2.3 | no trial arm names this drug |
| Pupillary reflex impaired | 35 | 8.6 6.2–12.1ROR 8.7 · calibrated p 0.059 | 7.9 EB05 5.8 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious n=34 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Areflexia | 51 | 8.5 6.5–11.3ROR 8.5 · calibrated p 0.059 | 8.0 EB05 6.2 · IC025 +2.5 3/3 methods agree | Not in label — unassessed | serious n=51 · ♀ 100% (drug 66%) · 100% clinician | no trial arm names this drug |
| Skin plaque | 157 | 8.4 7.2–9.8ROR 8.4 · calibrated p 0.059 | 8.1 EB05 7.1 · IC025 +2.7 3/3 methods agree | Not in label — unassessed | serious n=142 · ♀ 87% (drug 66%) | no trial arm names this drug |
| Infusion site pruritus | 58 | 8.4 6.5–10.8ROR 8.4 · calibrated p 0.062 | 7.9 EB05 6.3 · IC025 +2.5 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious n=31 · ♀ 100% (drug 66%) | no trial arm names this drug |
| Neurodermatitis | 64 | 8.3 6.4–10.6ROR 8.3 · calibrated p 0.064 | 7.8 EB05 6.3 · IC025 +2.5 3/3 methods agree | Not in label — unassessed | – | no trial arm names this drug |
| Clonus | 49 | 8.0 6.1–10.6ROR 8.0 · calibrated p 0.071 | 7.5 EB05 5.8 · IC025 +2.4 3/3 methods agree | Not in label — unassessed | serious n=47 · 100% clinician | no trial arm names this drug |
| Long qt syndrome | 43 | 8.0 5.9–10.8ROR 8.0 · calibrated p 0.072 | 7.4 EB05 5.7 · IC025 +2.4 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious n=43 · 100% clinician | no trial arm names this drug |
Trial evidence (ClinicalTrials.gov)
Most frequently reported reactions
By raw co-report count, regardless of disproportionality. Common terms here are often the illness itself or generic outcomes.
| Reaction | Reports | PRR 95% CI · ROR · χ²/p | EBGM EB05 · IC025 | Label screen | Serious-only & strata | Trial cross-check |
|---|---|---|---|---|---|---|
| Pruritus (itching) | 3,235 | 3.8 3.7–3.9ROR 4.0 · calibrated p 0.375 | 3.8 EB05 3.7 · IC025 +1.9 3/3 methods agree | Likely indication confounding term in indications; also in warnings | serious PRR 3.8 | no trial arm names this drug |
| Drug ineffective (drug did not work) | 3,221 | 1.1 1.0–1.1ROR 1.1 · calibrated p 0.365 | 1.1 EB05 1.1 · IC025 +0.1 | Reporting / coding artifact | serious PRR 1.4 | no trial arm names this drug |
| Nausea | 2,855 | 1.6 1.5–1.7ROR 1.6 · calibrated p 0.733 | 1.6 EB05 1.6 · IC025 +0.6 | Not in label — unassessed | serious PRR 1.7 | no trial arm names this drug |
| Fatigue (tiredness) | 2,764 | 1.6 1.5–1.6ROR 1.6 · calibrated p 0.714 | 1.6 EB05 1.5 · IC025 +0.6 | Not in label — unassessed | serious PRR 1.6 | no trial arm names this drug |
| Toxicity to various agents | 2,502 | 6.7 6.4–6.9ROR 7.0 · calibrated p 0.099 | 6.6 EB05 6.4 · IC025 +2.7 3/3 methods agree | Not in label — unassessed | serious PRR 6.0 · 96% clinician | no trial arm names this drug |
| Off label use (used outside approved label) | 2,475 | 1.3 1.2–1.3ROR 1.3 · calibrated p 0.492 | 1.3 EB05 1.2 · IC025 +0.3 | Reporting / coding artifact | serious PRR 1.3 | no trial arm names this drug |
| Pain | 2,333 | 1.7 1.6–1.7ROR 1.7 · calibrated p 0.778 | 1.7 EB05 1.6 · IC025 +0.7 | Not in label — unassessed | serious PRR 1.7 | no trial arm names this drug |
| Headache | 2,302 | 1.6 1.6–1.7ROR 1.7 · calibrated p 0.745 | 1.6 EB05 1.6 · IC025 +0.6 | Labeled adverse reaction exact term | serious PRR 1.8 | no trial arm names this drug |
| Completed suicide (death by suicide) | 2,239 | 12.1 11.6–12.6ROR 12.6 · calibrated p 0.014 ✓ | 11.8 EB05 11.4 · IC025 +3.5 3/3 methods agree | Outcome field, not a reaction | serious PRR 10.3 · 99% clinician | no trial arm names this drug |
| Rash | 2,143 | 2.2 2.1–2.3ROR 2.2 · calibrated p 0.928 | 2.2 EB05 2.1 · IC025 +1.1 3/3 methods agree | Labeled adverse reaction exact term | serious PRR 1.9 | no trial arm names this drug |
| Diarrhoea (diarrhea) | 2,014 | 1.4 1.3–1.4ROR 1.4 · calibrated p 0.578 | 1.4 EB05 1.3 · IC025 +0.4 | Not in label — unassessed | serious PRR 1.3 | no trial arm names this drug |
| Dyspnoea (shortness of breath) | 1,977 | 1.5 1.5–1.6ROR 1.6 · calibrated p 0.688 | 1.5 EB05 1.5 · IC025 +0.6 | Not in label — unassessed | serious PRR 1.5 | no trial arm names this drug |
| Anxiety | 1,918 | 3.0 2.9–3.1ROR 3.1 · calibrated p 0.604 | 3.0 EB05 2.9 · IC025 +1.5 3/3 methods agree | Likely indication confounding term in indications | serious PRR 3.1 | no trial arm names this drug |
| Vomiting | 1,801 | 1.7 1.6–1.8ROR 1.7 · calibrated p 0.787 | 1.7 EB05 1.6 · IC025 +0.7 | Not in label — unassessed | serious PRR 1.7 | no trial arm names this drug |
| Dizziness | 1,670 | 1.5 1.4–1.6ROR 1.5 · calibrated p 0.644 | 1.5 EB05 1.4 · IC025 +0.5 | Not in label — unassessed | serious PRR 1.6 | no trial arm names this drug |
Unlabeled candidate signals
These flagged terms were not found in the FDA label text and do not match an artifact pattern. They are the pairs that would merit a structured assessment (temporality, dose-response, biological plausibility, consistency across databases, trial or cohort evidence). The screen has not done that; string-matching misses label wording, and a strong PRR can still be stimulated reporting, co-medication, or the disease itself.
- Chemical submission — n=46, PRR 101.2
- Neuroblastoma recurrent — n=37, PRR 99.5
- Persistent genital arousal disorder — n=34, PRR 75.5
- Peripheral circulatory failure — n=34, PRR 40.0
- Victim of chemical submission — n=38, PRR 30.6
- Suspected suicide — n=250, PRR 24.4
- Bronchial wall thickening — n=35, PRR 22.4
- Chronic kidney disease-mineral and bone disorder — n=48, PRR 20.6
- Victim of crime — n=52, PRR 20.3
- Dry age-related macular degeneration — n=43, PRR 17.8
Want to assess one of these properly? The runbook describes the Bradford Hill / trial-evidence workflow used on the assessment page, and handoff_top1000_signals.csv lists the strongest unassessed pairs across all drugs.
Common questions
What are the most reported side effects of Hydroxyzine?
In FDA FAERS, the most frequently co-reported reaction terms for Hydroxyzine are pruritus, nausea, fatigue, toxicity to various agents, pain, headache. These are report counts, not rates: FAERS has no denominator, reporting is voluntary and uneven, and a term can be reported because of the illness being treated rather than the drug.
Does Hydroxyzine have an FDA boxed warning?
No. The FDA label retrieved for Hydroxyzine has no boxed warning; see the label's Warnings and Precautions for the recognised risks.
Do FAERS signals prove that Hydroxyzine causes these side effects?
No. A disproportionality signal (PRR, ROR) means a reaction is reported more often with this drug than with others in the database. That can reflect a real effect, but also the disease being treated, stimulated reporting after news or litigation, co-medications, or how reports are coded. Causality needs temporality, dose-response, biological plausibility, consistency across data sources and, ideally, trial or cohort evidence. This page screens each term against the FDA label and ClinicalTrials.gov results; it does not establish causation.
Sources & methods
- FDA label via openFDA (set ID 89901966-724b-4773-98b8-ea663ceabd53, effective 20241025; matched on
openfda.generic_name.exact:"HYDROXYZINE") - Bayesian shrinkage measures computed offline over all 1,317,300 cached pairs: BCPNN information component (IC, with Norén closed-form IC025) and MGPS empirical-Bayes geometric mean (EBGM, EB05) with a two-component gamma prior fitted by maximum marginal likelihood (α₁=0.57, β₁=0.02, α₂=1.42, β₂=0.70, w=0.17); unstratified
- FAERS pair statistics from the OpenPV build of 2026-09-14 (openFDA
count=aggregation, fieldpatient.drug.openfda.generic_name.exact, 1,173 reaction terms, min 3 co-reports); PRR/ROR with 95% CI, chi-square with Yates correction - Serious-only and stratified counts (serious:1, patient.patientsex, primarysource.qualification) from openFDA count queries; serious-only PRR uses the drug serious report total and the term global serious total (N_serious=11,882,979); strata shown only when n ≥ 20
- Seriousness and sex counts from openFDA
count=serious,patient.patientsex,seriousnessdeath - ClinicalTrials.gov API v2 (query
HYDROXYZINE, results-bearing studies sorted by enrollment)
Page generated 2026-10-14. Label and PubChem text are retrieved automatically and may lag the current label; always check the current prescribing information. OpenPV is a beta research tool of the Open Source Medicine Foundation.