This sheet is about exposure to hydroxyzine in pregnancy and while breastfeeding. This information is based on published research studies. It should not take the place of medical care and advice from your healthcare providers.
What is Hydroxyzine?
Hydroxyzine (Vistaril®, Atarax®) is an antihistamine. Antihistamines work by helping the body lower the response to allergens including pollen, nuts, or skin irritants, which can make you itch or develop hives. Some antihistamines, like hydroxyzine, are used to help treat anxiety, nausea, tension, or to help you sleep better.
Sometimes when women find out they are pregnant, they think about changing how they take their medication, or stopping their medication altogether. However, it is important to talk with your healthcare providers before making any changes to how you take your medication. Your healthcare providers can talk with you about the benefits of treating your condition and the risks of untreated illness during pregnancy.
The product label for hydroxyzine recommends women who are pregnant not use this medication. This is because there is not enough information available on the use of hydroxyzine to know what effect, if any, it could have on a human pregnancy. However, the benefit of using hydroxyzine might outweigh possible risks. Your healthcare provider can talk with you about using hydroxyzine and what treatment is best for you.
I take hydroxyzine. Can it make it harder for me to get pregnant?
Studies have not been done to see if taking hydroxyzine can make it harder to get pregnant.
Does taking hydroxyzine increase the chance of miscarriage?
Miscarriage is common and can occur in any pregnancy for many different reasons. In one study of 100 women taking hydroxyzine during pregnancy, an increased chance of miscarriage was not reported.
In animal studies, high doses (more than what would be given to humans) of hydroxyzine were associated with an increased chance of miscarriage.
Does taking hydroxyzine increase the chance of birth defects?
Birth defects can happen in any pregnancy for different reasons. Out of all babies born each year, about 3 out of 100 (3%) will have a birth defect. We look at research studies to try to understand if an exposure, like hydroxyzine, might increase the chance of birth defects in a pregnancy.
In studies involving over 200 women who used hydroxyzine throughout their pregnancy, no increase in birth defects was reported.
Does taking hydroxyzine in pregnancy increase the chance of other pregnancy-related problems?
It is not known if taking hydroxyzine alone can increase the chance of preterm delivery (birth before 37 weeks), or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams]).
I need to take hydroxyzine throughout my entire pregnancy. Will it cause withdrawal symptoms in my baby after birth?
The use of hydroxyzine during pregnancy has been reported to cause temporary symptoms in newborns soon after birth. These symptoms are sometimes referred to as withdrawal. Two cases of neonatal withdrawal have been reported when the mother used hydroxyzine in the 4 weeks leading up to delivery. One baby had one seizure, and the other experienced jitteriness, jerking movements, and problems with feeding. Not all babies exposed to hydroxyzine will have these symptoms. It is important that your healthcare providers know you are taking hydroxyzine so that if symptoms occur your baby can get the care that is best for them.
Does taking hydroxyzine in pregnancy affect future behavior or learning for the child?
Studies have not been done to see if hydroxyzine can increase the chance of behavior or learning issues for the child.
Breastfeeding while taking hydroxyzine:
It is not known if hydroxyzine passes into breast milk. Taking occasional doses of hydroxyzine is not expected to cause side effects in a breastfed infant. Larger doses or taking hydroxyzine for a long period of time might increase the chance for side effects such as drowsiness, irritability, or lower milk supply. There are reports of irritability and drowsiness in infants exposed to hydroxyzine through breast milk. If you suspect the baby has any symptoms, contact the child’s healthcare provider.
The product label for hydroxyzine recommends women who are breastfeeding not use this medication. But the benefit of using hydroxyzine and breastfeeding might outweigh possible risks. Your healthcare providers can talk with you about using hydroxyzine and what treatment is best for you. Be sure to talk to your healthcare provider about all your breastfeeding questions.
If a man takes hydroxyzine, could it affect fertility or increase the chance of birth defects?
Studies have not been done to see if hydroxyzine could affect men’s fertility (ability to get a woman pregnant) or increase the chance of birth defects. In general, exposures that fathers or sperm donors have are unlikely to increase risks to a pregnancy. For more information, please see the MotherToBaby fact sheet Paternal Exposures at https://mothertobaby.org/fact-sheets/paternal-exposures-pregnancy/.
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