Oral steroids ( prednisone , [ Medrol ]) can help severe cases of hives in the short term, but their usefulness is limited by the fact that many cases of hives last too long for steroid use to be continued safely. Other treatments have been used for urticaria as well, including montelukast ( Singulair ), ultraviolet radiation , antifungal antibiotics, agents that suppress the immune system, and tricyclic antidepressants ( amitriptyline [ Elavil , Endep ], nortriptyline [ Pamelor , Aventyl], doxepin [Sinequan, Adapin]). Evidence to support the benefit of such treatments is sparse. In ordinary cases, they are rarely needed. A new treatment recently available for chronic urticaria is the monthly subcutaneous injection of a monoclonal antibody, omalizumab ( Xolair ), directed against the IgE receptor on human mast cells.
1. Bernstein JA, Lang DM, Khan DA et al. The diagnosis and management of acute and chronic urticaria: 2014 update. J Allergy Clin Immunol. 2014;133:1270-7
2. Kaplan AP. Therapy of chronic urticaria: a simple, modern approach. Ann Allergy Asthma Immunol . 2014;112:419-25
3. Zuraw BL, Bernstein JA, Lang DM et al. A focused parameter update: hereditary angioedema, acquired C1 inhibitor deficiency, and angiotensin-converting enzyme inhibitor-associated angioedema. J Allergy Clin Immunol . 2013;131:1491-3
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Treatment with prescription medications
Some individuals may eventually need or want prescription medicine to treat their angioedema. Depending upon the case and other factors, different ones may be prescribed. Some general information is available below, however, it is not intended to be used for any particular individual or case.
In mild cases of angioedema, longer-lasting antihistamines are frequently given. More moderate angioedema may require something like corticosteroids. Medicines which block H1 and H2 are also used for treatment in cases that do not seem to go away as easily, however, these are not approved by the . FDA for treating angioedema, and are actually supposed to be antidepressants.
In general, avoiding triggers is recommended to relieve cases of angioedema. However, additional treatment may be asked for by the patient for relief of current symptoms, or may be useful in other circumstances. For instance, angioedema can rarely lead to a condition known as anaphylactic shock, an allergic reaction which is a medical emergency and life-threatening situation. In such a case, adrenaline is administered.
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