Which medications are used in the treatment of cholinergic urticaria?

Updated: Feb 12, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Prophylactic options are a good approach for inducible urticarias, whether with second-generation H1 antihistamines, H2 antihistamines, hydroxyzine, doxepin, oral glucocorticoids, omalizumab/anti-IgE therapy, phototherapy, physical desensitization, or immunomodulatory agents, individualized for each patient. [37] As previously mentioned, antihistamines, including cetirizine, are used in the treatment of cholinergic urticaria. The response to cetirizine is important because some of the antihistaminic effect has been attributed to antimuscarinic activity. Loratadine and desloratadine are other antihistamines that can be employed in therapy.

Treatment approaches to cholinergic urticaria also include anti–immunoglobulin E therapy and combination therapy (eg, cetirizine, montelukast, propranolol). [38, 39] Use of omalizumab for refractory cholinergic urticaria has been advocated [40]  and evaluated as safe and effective. [41, 42]

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