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Serious but rare risks include hypoglycemia (low blood sugar), acute pancreatitis (severe, persistent abdominal pain often with vomiting), acute gallbladder disease (sudden right-upper abdominal pain that may radiate to the shoulder), non-arteritic anterior ischemic optic neuropathy (sudden, potentially permanent vision loss), mood changes, and severe allergic reactions with breathing difficulty or swelling of the lips, tongue, or throat

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Many patients use hydroxyzine for short-term anxiety relief or as a sleep aid during stressful periods