Second-generation H1-receptor blockers such as fexofenadine are the first-line treatment in acute urticaria. Avoidance of the offending substance is the cornerstone of management. Patients should be educated about cross-reactive proteins and avoiding exposure.
First-generation antihistamines such as diphenhydramine are sedating and are no longer the first-line treatment for urticaria. H2 antagonists such as famotidine are not effective when used as single agents for urticaria; however, combined with an H1 antagonist, they have been shown to increase efficacy when used in combination with an H1 antagonist.
If urticaria is present with angioedema and systemic symptoms, which raises concern for anaphylaxis, epinephrine should be administered intramuscularly.
Learn more about fexofenadine.
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Cite this: William James. Fast Five Quiz: Urticaria (Hives) - Medscape - Dec 12, 2022.