Lipophilic Inverse Histamine H1 & Weak 5-HT2A Rapid Anxiolytic • Rx

Hydroxyzine Pamoate

Brand Reference: Vistaril

Medically Reviewed by Dr. Hannah Lindqvist, MD, PhD (NPI #1457952647)
82.80%
Patient “Worth It”
31 verified logs
$5.70
Lowest Monthly Cash

Hydroxyzine Pamoate Clinical & Real-World Cost Fact Matrix

Metric Verified Benchmark Source
Hydroxyzine Pamoate RxNorm Concept ID 5553 U.S. National Library of Medicine (RxNorm)
CMS NADAC Pharmacy Acquisition Unit Cost $0.0620 / unit CMS Medicaid NADAC Weekly Feed
Walk-In Chain Pharmacy Cash Average $29.00 / mo CMS NADAC + U.S. Retail Markup Index
Mark Cuban Cost Plus Wholesale Price $5.70 / mo Cost Plus Drugs Wholesale Feed
Community Mean Out-of-Pocket Paid $7.20 / mo 31 Zero-PHI Verified Patient Logs
INSTANT PRESCRIPTION & CASH ROUTING

Verified Online Prescribers & Wholesale Pharmacies for Hydroxyzine Pamoate

DotMD Club Members get $29 flat-rate script renewals →
Mark Cuban Cost Plus Drugs (Wholesale Pharmacy)
Requires an existing doctor prescription. Need a script? Pair with a $29 DotMD Club TeleMed consult.
$5.70/mo
Wholesale Cash Price
View Wholesale Rx →
Hims & Hers Direct Cash Pharmacy (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~2 days • Rx included in monthly tier
$ 49.00
All-In Monthly
Start Online Visit →
Sesame Direct Cash-Pay Prescriber Network (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~1 days
$ 29.00
Consult / Starting Tier
Start Online Visit →
Virtual Psychiatric Medication Management (Online Doctor Consult + Delivery)
Asynchronous physician review included • Ships in ~1 days
$ 39.00
Consult / Starting Tier
Start Online Visit →

Hydroxyzine Pamoate Clinical Pharmacology & DailyMed Monograph

RxCUI 5553 • NDC 00378-5152-01

Lipophilic piperazine H1 inverse agonist (preferential pamoate salt CNS penetration) with secondary cortical 5-HT2A antagonism and low muscarinic M1 burden—aborting acute autonomic panic surges and pruritus within 25 minutes without controlled-substance addiction risk.

Across 31 community cost disclosures for Hydroxyzine Pamoate (Vistaril), cash buyers routing around $29.00 retail markups capture a 80% discount ($5.70/mo benchmark vs $0.0620 NADAC acquisition).

Following administration (25 mg PO PRN anxiety (up to TID)), Hydroxyzine Pamoate achieves 80% oral bioavailability and 15–30 minutes acute somatic calm onset, governed by a 20 hours (metabolized to cetirizine) terminal half-life through hepatic alcohol dehydrogenase & cyp3a4 oxidation to active cetirizine (45%).

Before initiating Hydroxyzine Pamoate at 25 mg PO PRN anxiety (up to TID), clinical safety checklists rule out prolonged qtc interval (> 470 ms); first trimester pregnancy; porphyria. Logged tolerability patterns center on somnolence (34% of reports), dry mouth (16% of reports).

Half-Life
20 hours (metabolized to cetirizine)
Bioavailability
80% oral
Metabolism & Clearance
Hepatic alcohol dehydrogenase & CYP3A4 oxidation to active cetirizine (45%)
Clinical Onset
15–30 minutes acute somatic calm

Standard Adult Titration & Dosages

25 mg PO PRN anxiety (up to TID) 50 mg PO QHS sleep onset

Absolute & Relative Contraindications

  • Prolonged QTc interval (> 470 ms)
  • First trimester pregnancy
  • Porphyria

Logged Side-Effect Incidence (31 Reports)

Somnolence 34%
Dry mouth 16%

Hydroxyzine Pamoate Patient Dosage Logs & Out-of-Pocket Cost Ledger

Across 31 verified cash-pay logs, Hydroxyzine Pamoate achieves a 82.80% Worth-It rating with out-of-pocket spend averaging $7.20/mo versus $29.00/mo walk-in retail.

15-Second Anonymous Micro-Log (Zero-PHI Architecture)

Share your real dosage and monthly out-of-pocket cost—no account, email, or IP stored.

Effectiveness: 5/5 • Worth It Dosage: 25 mg PO PRN anxiety (up to TID) • Paid: $5.02/mo via Cost Plus Drugs
Somnolence

Switched to Cost Plus Drugs at 25 mg PO PRN anxiety (up to TID) for Hydroxyzine Pamoate; monthly out-of-pocket dropped to $5.02 compared with $29.00 retail.

Effectiveness: 5/5 • Worth It Dosage: 50 mg PO QHS sleep onset • Paid: $5.81/mo via TeleMed

Completed 10 weeks on Hydroxyzine Pamoate (50 mg PO QHS sleep onset). Zero notable side effects on steady dosing.

Effectiveness: 4/5 • Worth It Dosage: 25 mg PO PRN anxiety (up to TID) • Paid: $6.61/mo via Compounding
Somnolence

Consistent biomarker response on 25 mg PO PRN anxiety (up to TID) Hydroxyzine Pamoate sourced via Compounding ($6.61/mo cash pay without insurance prior authorization).