Two medicines, side by side
Hydroxyzine vs alprazolam
Hydroxyzine and alprazolam are both labeled for anxiety. Drugs@FDA records approvals of hydroxyzine since 1956 and of alprazolam since 1981. Pharmacies paid $0.0326 per hydroxyzine HCl 25 mg tablet and $0.0236 per alprazolam 0.25 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, hydroxyzine is an antihistamine and alprazolam a benzodiazepine.
Check it at the source: the hydroxyzine FDA label on DailyMed (effective March 3, 2026); the alprazolam FDA label on DailyMed (effective January 18, 2023).
Highlights of the hydroxyzine record
Hydroxyzine (Atarax) · label of March 3, 2026
Used for
From the label: indicationsFor 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. […]
On the market
- Earliest approval on file
- April 12, 1956
- Generic labelers
- 61 labelers
- Pharmacy cost
- $0.0326 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 18
Highlights of the alprazolam record
Alprazolam (Xanax) · label of January 18, 2023
RISKS FROM CONCOMITANT USE WITH OPIOIDS; ABUSE, MISUSE, AND ADDICTION; and DEPENDENCE AND WITHDRAWAL REACTIONS
Concomitant use of benzodiazepines and opioids may result in profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs for patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required.
Used for
From the label: indicationsXANAX is indicated for the: • acute treatment of generalized anxiety disorder (GAD) in adults. • treatment of panic disorder (PD), with or without agoraphobia in adults. XANAX is a benzodiazepine indicated for the: • Acute treatment of generalized anxiety disorder in adults. ( 1 ) • Treatment of panic disorder with or without agoraphobia in adults.
On the market
- Earliest approval on file
- October 16, 1981
- Generic labelers
- 30 labelers
- Pharmacy cost
- $0.0236 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 23
Source: FDA drug labels via openFDA (Hydroxyzine label of March 3, 2026, Alprazolam label of January 18, 2023); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do hydroxyzine and alprazolam differ on the record?
In FDA's classes, hydroxyzine is an antihistamine and alprazolam a benzodiazepine.
Only the alprazolam label carries a boxed warning.
Generics: hydroxyzine since 1979; alprazolam since 1993 (Drugs@FDA).
DEA schedule: hydroxyzine none; alprazolam CIV.
| Hydroxyzine | Alprazolam | |
|---|---|---|
| Labeled for | Anxiety, Alcohol use disorder | Anxiety |
| Pharmacologic class | Antihistamine | Benzodiazepine |
| How it works (label) | n/a | Alprazolam is a 1,4 benzodiazepine. |
| Half-life (label) | n/a | Elimination The mean plasma elimination half-life (T 1/2 ) of alprazolam is approximately 11.2 hours (range: 6.3 to 26.9 hours) in healthy adults. |
| Earliest approval on file (Drugs@FDA) | April 12, 1956 | October 16, 1981 |
| First generic approved | August 24, 1979 | October 19, 1993 |
| Generic labelers (NDC) | 61 labelers | 30 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0326 per tablet (Hydroxyzine HCl 25 mg tablet) | $0.0236 per tablet (Alprazolam 0.25 mg tablet) |
| 12-month price change | -12% | -1% |
| Boxed warning | No | Yes |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 18 | 23 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 50,844 | 204,916 |
| DEA schedule | none | CIV |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Alprazolam label, drug interactionsCNS Depressants Clinical implication The benzodiazepines, including alprazolam, produce additive CNS depressant effects when coadministered with other CNS depressants.
Source: FDA drug labels via openFDA
What next?
- Alternatives to hydroxyzine
- every medicine labeled for the same conditions