Whealy Doses

High doses of antihistamines alleviated urticarial wheals better than the standard dose.

The European Academy of Allergy and Clinical Immunology (EAACI) recommends nonsedating H₁ antihistamines as first-line therapy for chronic urticaria. Second-generation antihistamines, such as levocetirizine, desloratadine, and fexofenadine, have long half-lives, lack cardiotoxicity, and do not usually cause anticholinergic effects or drowsiness. Controlled trials have shown efficacy and safety, but fewer than half of treated patients respond well enough. Higher doses may work better. In fact, EAACI guidelines recommend dose escalations of up to 4 times the conventional dose. However, controlled trials have not assessed the effects of these drugs in such high doses.

European investigators conducted a double-blind, randomized trial of the effe…

Reviewing Author

Mark V. Dahl, MD

Disclosures

Consultant / Advisory board Ulthera, Inc.; AuBio LifeSciences, LLC; Paris Therapeutics

Equity Elorac, Inc.; Makucell, Inc.; Paris Therapeutics

Editorial boards UpToDate

Leadership positions in professional societiesNational Rosacea Society (Chairman, Medical Board)