I had a sudden outbreak of hives. Are my medications appropriate?

Question

Hello doctor,

This is regards to my urticaria problem. I had a chronic urticaria three years back, for which I underwent a course of Loratadine and Xyzal-M (Levocetirizine andMontelukast) for close to one and a half years and was keeping well. All of a sudden, I had a severe outbreak of hives last week and was put on Dazit-M (Montelukast and Desloratadine), Allegra 180 (Fexofenadine hydrochloride) and Xyzal along with Methylprednisolone (8 milligrams). This time it is so severe and after three days it is not coming down. I need your advice on my current condition and if my medications are appropriate.

Answer 1

Hi,

I am glad you chose icliniq for your medical-related queries.

I understand your concern and will try to help you with it.

At the moment, you are having acute exacerbation precipitated by one of the exaggerating factors like artificial flavoring agents, any drugs or some chemical agents. You have already been prescribed steroid which is Methylprednisolone for three days and some other antiallergic medicine as well. I will recommend you to be patient for one more week and continue the same medication. If in case there is no improvement, only then I will recommend having another short course of steroid. Meanwhile, I will ask you to please avoid readymade or take away meals, use bland products for washing, avoid perfumes deodorants, etc. I know this is difficult to do but avoid as much as you can. You can apply topical steroid lotion mixed with Vaseline lotion in equal parts and then apply on your hives two times daily. Please continue with your oral medicine in addition to this. In case you have any breathing difficulty then see a doctor on an emergency basis. Next time please send a picture of the lesion as well to know the extent of disease too.

Thank you for consulting me.

You can always reach me at icliniq.com.

Answer 2

Hi,

Welcome back to icliniq.com.

I read and understand your concern.

Well, as I told you earlier that any type of drug might be the cause of acute exacerbation of urticaria, and you have mentioned it could cause them. I recommend you not start these drugs immediately after your urticaria treatment. First, you should wait at least 3 weeks and if you feel that your stress symptom is getting worse or aggravating, then start your drug one by one; that is, first start with Betacap (Propranolol) for ten days, then after that, add your second drug. This is so if Betacap causes urticaria, it will be obvious within ten days of restarting it, or if the second drug is the cause, it will cause urticaria when you start it. This is how we find the culprit drug.

Looking forward to your response in order to help you.

Thank you.