Which medications are used in the treatment of chronic urticaria?

Updated: Jul 31, 2018
  • Author: Marla N Diakow, MD; Chief Editor: William D James, MD  more...
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Answer

The following medications can be used in the treatment of chronic urticaria:

  • Nonsedating H1 second-generation antihistamines: The mainstay of pharmacotherapy for chronic urticaria; they decrease the intensity of hives and pruritus in patients with mild chronic urticaria

  • Leukotriene antagonists: Shown to be superior to placebo in the treatment of patients with chronic urticaria but considered less effective than nonsedating antihistamines [2, 3] ; however, the 2 classes of agents can be combined

  • Colchicine and dapsone: May help patients who respond poorly to antihistamine therapy or who are known to have urticaria in which the inflammatory infiltrate is neutrophil-predominant

  • Systemic corticosteroids: Rarely, a short course may be prescribed for severe exacerbations of chronic urticaria, especially when accompanied by angioedema. Long-term use for treatment of patients with chronic urticaria should be avoided as much as possible because of the risk of adverse effects with systemic corticosteroids

  • Cyclosporine and methotrexate: May benefit patients with autoimmune urticaria [4, 5]

  • Levothyroxine: May benefit some patients with chronic urticaria, antithyroid antibodies, or Hashimoto thyroiditis

  • Omalizumab: May benefit some patients with chronic urticaria despite H1 antihistamine treatment

See Treatment and Medication for more detail.


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