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Suggest treatment for chronic hives

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Posted on Mon, 14 Nov 2016
Question: Good Morning, I am a female, age 74 and have developed chronic hives in the past year. I have undergone allergy testing with minor results, i.e. dust, bee pollen. The hives I experience are unbearable with intense itching and burning. Benedryl does not seem to work . This problem has consumed my life....I can't work, I can't sleep or concentrate on any projects. Is there something that I can take to alleviate the symptoms.
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Answered by Dr. Michelle Gibson James (59 minutes later)
Brief Answer:
may go up to 4 times upper limit of non drowsy anti histamine

Detailed Answer:
HI, thanks for using healthcare magic

Chronic urticaria can be difficult to manage and to have to deal with on a daily basis.

There are different options but unfortunately it cannot be guaranteed that these would help you:
(1) Consider the use of a non drowsy anti histamine instead of drowsy one. The dose of the non drowsy can be increased to up to 4 times the normal upper limit according to the european academy of allergy and immunology.

Initially the dose can be doubled if needed. This includes medications such as levocetirizine (xyzal)or cetirizine (zyrtec) or fenofexadine (allegra)

(2)some persons have worse itching at night. If this is the case for you then you can add a drowsy anti histamine at night (eg benadryl)

(3)add montelukast to the increased dose of the anti histamines

(4)If the increased antihistamines and montelukast are not effective, then your doctor may want to try to use oral steroids.
These would be titrated down to the lowest possible effective dose and use on alternate days to suppress the symptoms

I hope that one of these are effective for you, if not there are stronger medications
Feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16810 Questions

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Suggest treatment for chronic hives

Brief Answer: may go up to 4 times upper limit of non drowsy anti histamine Detailed Answer: HI, thanks for using healthcare magic Chronic urticaria can be difficult to manage and to have to deal with on a daily basis. There are different options but unfortunately it cannot be guaranteed that these would help you: (1) Consider the use of a non drowsy anti histamine instead of drowsy one. The dose of the non drowsy can be increased to up to 4 times the normal upper limit according to the european academy of allergy and immunology. Initially the dose can be doubled if needed. This includes medications such as levocetirizine (xyzal)or cetirizine (zyrtec) or fenofexadine (allegra) (2)some persons have worse itching at night. If this is the case for you then you can add a drowsy anti histamine at night (eg benadryl) (3)add montelukast to the increased dose of the anti histamines (4)If the increased antihistamines and montelukast are not effective, then your doctor may want to try to use oral steroids. These would be titrated down to the lowest possible effective dose and use on alternate days to suppress the symptoms I hope that one of these are effective for you, if not there are stronger medications Feel free to ask any other questions