2. If the non-drowsy antihistamine pills do not work, try:
- Hydroxyzine (Vistaril)
- Diphenhydramine (Benadryl)
- Chlorpheniramine (Chlor-Trimeton)
Check with your doctor before taking any of these medications if you are pregnant or breastfeeding, have a chronic medical condition, or are taking other medications.
3. Try other medications.
If antihistamines alone don’t relieve your symptoms, other drugs that may help include:
- Histamine (H-2) blockers. Examples include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid) and famotidine (Pepcid). Side effects range from digestive problems to headache.
- Anti-inflammation medications. Oral corticosteroids, such as prednisone, can help lessen swelling, redness and itching. These usually are used only for a short time to control severe hives or angioedema because they can cause serious side effects.
Corticosteroids creams applied to the skin usually aren’t effective for chronic hives. Corticosteroids can weaken your immune system, making it easier for you to get an infection or worsening an infection you already have.
- Antidepressants. The tricyclic antidepressant doxepin (Zonalon), used in cream form, can help relieve itching. This drug may cause dizziness and drowsiness.
4. Ask about other options.
Several medications under study show promise for people whose chronic hives resist treatment:
- An injectable asthma drug. Several studies show the drug omalizumab (Xolair) is very effective against difficult-to-treat chronic hives, without side effects. But it is more costly than other options and is not usually covered by insurance.
- 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). Side effects may include behavior and mood changes.
- Cyclosporine. The drug cyclosporine (Gengraf, Neoral, others) affects the immune system and provides relief from chronic hives. Possible side effects range from headache and nausea to an increased risk of infection and reduced kidney function.
- Tacrolimus. Similar to cyclosporine, this drug reduces the immune system response that causes hives. And it, too, may cause a range of side effects, from minor to serious.
- Mycophenolate. This immune-suppressing drug also improves hives signs and symptoms. But for pregnant women, it increases the risk of miscarriage and birth defects.
Visit the BlackDoctor.org Allergy center for more articles.