Treatment

Your doctor will likely recommend you treat your symptoms with home remedies, such as over-the-counter antihistamines. If self-care steps don't help, talk with your doctor about finding the prescription medication or combination of drugs that works best for you. Usually, an effective treatment can be found.

Antihistamines

Taking nondrowsy antihistamine pills daily helps block the symptom-producing release of histamine. They have few side effects. Examples include:

  • Loratadine (Claritin)
  • Fexofenadine (Allegra)
  • Cetirizine (Zyrtec)
  • Desloratadine (Clarinex)

If the nondrowsy antihistamines don't help you, your doctor may increase the dose or have you try the type that tends to make people drowsy and is taken at bedtime. Examples include hydroxyzine pamoate (Vistaril) and doxepin (Zonalon).

Check with your doctor before taking any of these medications if you are pregnant or breast-feeding, have a chronic medical condition, or are taking other medications.

Other medications

If antihistamines alone don't relieve your symptoms, other drugs may help. For example:

  • Histamine (H-2) blockers. These medications, also called H-2 receptor antagonists, are injected or taken orally. Examples include cimetidine (Tagamet HB), ranitidine (Zantac) and famotidine (Pepcid).
  • Anti-inflammation medications. Oral corticosteroids, such as prednisone, can help lessen swelling, redness and itching. These are generally for short-term control of severe hives or angioedema because they can cause serious side effects if taken for a long time.
  • Antidepressants. The tricyclic antidepressant doxepin (Zonalon), used in cream form, can help relieve itching. This drug may cause dizziness and drowsiness.
  • Asthma drugs with antihistamines. Medications that interfere with the action of leukotriene modifiers may be helpful when used with antihistamines. Examples are montelukast (Singulair) and zafirlukast (Accolate).
  • Man-made (monoclonal) antibodies. The drug omalizumab (Xolair) is very effective against a type of difficult-to-treat chronic hives. It's an injectable medicine that's usually given once a month.
  • Immune-suppressing drugs. Options include cyclosporine (Gengraf, Neoral, others) and tacrolimus (Astagraft XL, Prograf, Protopic).
July 06, 2017
References
  1. Hives. American Academy of Dermatology. http://www.aad.org/dermatology-a-to-z/diseases-and-treatments/e---h/hives. Accessed April 25, 2017.
  2. Hives (urticaria). American College of Allergy, Asthma and Immunology. http://www.acaai.org/allergist/allergies/Types/skin-allergies/hives/Pages/default.aspx. Accessed April 25, 2017.
  3. Khan DA. Chronic urticaria: Standard management and patient education. http://www.uptodate.com/home. Accessed April 25, 2017.
  4. Goldsmith LA, et al., eds. Urticaria and angioedema. In: Fitzpatrick's Dermatology in General Medicine. 8th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.mhmedical.com. Accessed April 25, 2017.
  5. Khan DA. Chronic urticaria: Treatment of refractory symptoms. https://www.uptodate.com/home. Accessed April 25, 2017.
  6. Bernstein JA, et al., eds. The diagnosis and management of acute and chronic urticarial: 2014 update. Journal of Allergy and Clinical Immunology. 2014;133:1270.
  7. Darlenski R, et al. Chronic urticaria as a systemic disease. Clinics in Dermatology. 2014;32:420.
  8. Casale TB. Omalizumab for chronic urticaria. Journal of Allergy and Clinical Immunology: In Practice. 2014;2:118.