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

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Shanza Ikram

Medically reviewed by

iCliniq medical review team

Published At March 14, 2018
Reviewed AtJuly 20, 2023

Patient's Query

Hello doctor,

This is regards to my urticaria problem. I had a chronic urticaria three years back, for which I underwent a course of Loratidine and Xyzal-M 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, Allegra 180 and Xyzal along with Methylprednisolone (8 mg).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.

Answered by Dr. Shanza Ikram

Hello,

Welcome to icliniq.com.

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.

Patient's Query

Hello doctor,

Thanks for your prompt response.

I am certainly feeling better. However, I have been taking antihistamine medications and methyl prednisone steroid for the last day. I have further queries and need your input. As I was under severe work stress, I have been taking Betacap 20 TR and Cipralex 5 mg (half a tablet) for almost 8 months. Since this urticaria outbreak, I am not taking them and would again want to start these dosages. Will it cause any outbreaks of hives?

Answered by Dr. Shanza Ikram

Hello,

Welcome back to icliniq.com.

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.

I hope you got my point.

Take care.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Shanza Ikram
Dr. Shanza Ikram

Dermatology

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