When treating patients with severe CSU, both the AAAI and EAACI/GA2LEN/ EDF/WAO guidelines encourage clinicians to first attempt to achieve symptom control by increasing the dose of the initially prescribed second-generation antihistamine, rather than prescribing multiple antihistamines. If symptom control is not achieved with higher-dose monotherapy, a leukotriene receptor agonist or low-dose corticosteroid therapy can be added.
Treating patients with several different antihistamines and prescribing a combination of antihistamines, antidepressant medications, and aspirin are not recommended treatments for patients with severe CSU.
Learn more about treating severe and refractory CSU.
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Cite this: William D. James. Fast Five Quiz: Chronic Spontaneous Urticaria - Medscape - Jun 15, 2020.