Cyproheptadine may be useful to suppress recurrent cold urticaria.
One study showed that the combination of a leukotriene receptor antagonist and a nonsedating antihistamine was superior to the antihistamine alone in treating chronic idiopathic urticaria.
In a study of 51 patients treated with cetirizine at a dosage of 10 mg once daily, 18 patients had an inadequate response and were randomized to further treatment with either cetirizine 20 mg once daily or olopatadine 5 mg twice daily.
Patients in the increased cetirizine dose group showed significant improvements in the severity of wheal and itching and in quality of life.
She estimated that about 20 gelcaps (1,000 mg of diphenhydramine) were missing, an extremely toxic amount even for a large adult.
The child had a seizure at home before emergency medical services (EMS) arrived.
After a second hemodialysis treatment, he was stable. Poison Control recommended giving him fluids to drink and observing at home. Case 3: An adult male was prescribed hydroxyzine (Atarax®), an antihistamine that causes drowsiness, to help him sleep.
The breathing tube was removed, and he was able to come off sedation and the medications that had been supporting his blood pressure. He took twice the dose recommended by his physician due to trouble sleeping. He called Poison Control in the middle of the night and was advised that antihistamines may sometimes cause restlessness instead of drowsiness, especially in higher doses.
The child was transferred to a regular medical floor on hospital day 3. Poison Control recommended that he speak with his doctor about an alternative medication for sleep.
Because of its significant sedative properties, it should be given at bedtime.
Topical therapy with 5% doxepin cream (Zonalon) or capsaicin may also be used in refractory cases.