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Best antihistamine for hives

Dr Karen Martin
Reviewed by Dr Karen MartinReviewed on 19.10.2023 | 2 minutes read

Hives (also known as urticaria) is an itchy raised rash usually caused by a reaction to a trigger such as food, pollen, viral infection, insect bites, or chemicals. Antihistamine medication prevents the level of histamine from rising in the body and reduces the symptoms of hives. Most antihistamines are available over the counter, such as tablets, liquids, and creams.

Doctor’s advice

Which antihistamine should I use?

Tablets and liquids have a greater effect than creams because they work throughout the body. There are many different antihistamine tablets available. Once-daily tablets include the medications loratadine, cetirizine, levocetirizine, and fexofenadine. Although these medications are the least drowsy of all the over-the-counter antihistamines, they are not as effective as others. Chlorpheniramine and diphenhydramine can be taken up to six times a day in adults and are often found to give more relief as they can be taken more often. They can cause more drowsiness compared to other antihistamines, so beware if you are driving or doing a job that requires you to be alert.

When to see the doctor

If you have tried over-the-counter antihistamines for your hives and find the symptoms persist without improvement, it may be time to consult your doctor. Your doctor may move to another class of prescription-only antihistamines. If this doesn’t work, your doctor may consider introducing an oral steroid. Steroids are comparatively stronger but can also cause far more significant side effects.

How to prevent hives from reoccurring?

The simplest and the best approach is to avoid the trigger causing the hives. If it is more difficult to avoid such triggers as dust and pollen, taking regular antihistamines may be beneficial, especially as the trigger may occur unknowingly.

Should anyone avoid it?

If you have severe kidney or liver problems, you should avoid taking antihistamines without your doctor knowing. Do not take drowsy antihistamines if you have breathing problems, glaucoma, or an enlarged prostate. If you are pregnant or breastfeeding, you should also speak to your doctor before taking medications. If you are unsure whether you can take an antihistamine for any other reason, such as medication interactions, speak to your pharmacist or doctor.

With all antihistamines, the most common side effect is feeling a bit drowsy. Even though some are less drowsy, any medication can still cause some drowsiness. Other side effects include dizziness and headaches. Allergic reactions are uncommon but possible with any medication. You should seek urgent medical attention if you experience an allergic reaction.

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This article has been written by UK-based doctors and pharmacists, so some advice may not apply to US users and some suggested treatments may not be available. For more information, please see our T&Cs.
Dr Karen Martin
Reviewed by Dr Karen Martin
Reviewed on 19.10.2023
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