What dose of hydroxyzine (antihistamine) can cause Eustachian tube dysfunction?

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Last updated: June 23, 2025View editorial policy

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From the Research

There is no specific dose of hydroxyzine that is known to directly cause Eustachian tube dysfunction, but standard therapeutic doses (25-100 mg for adults) may contribute to Eustachian tube issues through anticholinergic and drying effects on mucous membranes. Hydroxyzine, an antihistamine commonly used for anxiety, allergies, and as a sedative, can potentially affect the normal function of the Eustachian tube, which requires proper mucus production to maintain pressure equilibrium between the middle ear and the environment. The medication's ability to dry mucous secretions can potentially impact Eustachian tube function, especially in patients with pre-existing Eustachian tube problems, allergies, or upper respiratory conditions 1.

Key Considerations

  • Patients with pre-existing conditions may be more susceptible to this side effect
  • Staying well-hydrated while taking hydroxyzine may help minimize potential effects on the Eustachian tube
  • If you experience ear fullness, popping, or hearing changes while taking hydroxyzine, consult your healthcare provider for dosage adjustment or alternative medications
  • The most common side effects of hydroxyzine include sleepiness, weight gain, dry mouth, loss of concentration, and insomnia, but these are generally transient 1

Relevant Studies

  • A study on the effect of an antihistamine/decongestant on nasal and Eustachian tube function found that the medication improved Eustachian tube function in patients with allergic rhinitis 2
  • Another study on the effect of decongestant with or without antihistamine on Eustachian tube function found that the combination of an oral decongestant and antihistamine had a favorable effect on tubal function in children without a URI 3
  • However, a study on Eustachian tube function associated with histamine-induced and ragweed-induced rhinitis found that mild symptoms of allergic rhinitis may not cause significant Eustachian tube obstruction 4

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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