Many adults and children have experienced urticaria, itching, erythema…. Repeatedly affecting life, and go to the pharmacy to buy anti-allergic drugs, some are over-the-counter, some are prescription drugs, often confused and do not know how to choose. There are many questions in the process of medication and treatment of urticaria, such as:
- How long do I need to take antiallergic drugs for chronic urticaria?
- What should I do if the medication is under control, but urticaria occurs after scratching after stopping the medication?
- Which anti-allergy medicines are suitable for children and which cannot be used?
- Can chronic urticaria be vaccinated? ……
Dr. Zeng Dan from the Allergy Department of Yihe Shang explained these issues on “Yihe Science Popularization”, Share with everyone.
1, What is the difference between urticaria and chronic urticaria? Is it necessary to take anti-allergy medicine for chronic urticaria for at least three months?
Urticaria usually manifests as erythema and wheal, accompanied by itching, and the wheal can subside on its own. Lesions usually resolve within 30 minutes to 24 hours, after which the skin returns to its normal appearance. According to the course of the disease, urticaria is divided into acute urticaria and chronic urticaria.
The course of acute urticaria is less than 6 weeks, and there is usually a clear cause. On the one hand, actively look for triggers and remove them, usually soon enough.
The course of chronic urticaria is more than 6 weeks, and there are many pathogenic factors and many subtypes. For different types or different stages of urticaria, the medication time and avoidance factors are different.
Therefore, it is unscientific to say that it is unscientific to take anti-allergic drugs for the treatment of urticaria for at least three months. We should try our best to know who we are. type of urticaria, and then medication for that type of urticaria.
Domestic urticaria treatment guidelines point out that the course of treatment for chronic urticaria is generally not less than 1 month, and can be extended to 3-6 months if necessary. months, or more.
2, Have been taking antiallergic drugs (loratadine) before urticaria , the symptoms are under control, after stopping the drug, a large piece of urticaria will still appear after occasionally scratching, do I still need to take medicine?
The basic principle of drug treatment for urticaria is complete relief of clinical symptoms, which is mainly divided into two aspects: one There is no new rash, the other is no itching.
If there are large urticaria after scratching, it may be uncontrolled or combined with artificial urticaria (skin scratching urticaria). Measles), it is recommended to continue taking it. After the treatment is effective, the dose can be gradually reduced or stopped, and try not to scratch.
If the onset of chronic urticaria is more than 6 weeks, it is recommended to gradually reduce the dose and maintain the treatment with the smallest dose. Chronic urticaria The course of treatment is generally not less than 1 month, and can be extended to 3 to 6 months, or longer if necessary.
3, Can montelukast sodium be used to treat urticaria?
The symptoms of urticaria such as wheals and itching are mainly caused by the action of histamine. Therefore, Antihistamines are very effective in the treatment of urticaria.
In addition to histamine, other mast cell-related factors, such as leukotrienes and platelet-activating factor, are also involved in the pathogenesis of urticaria.
That is to say, even if the histamine is “solved”, the existence of other related factors may be the reason for the recurrent urticaria.
Montelukast sodium is a leukotriene receptor antagonist and is also used clinically to treat urticaria and as an antihistamine. a complementary treatment.
Montelukast sodium has a certain effect in the treatment of chronic urticaria, especially in refractory urticaria. But not first-line treatment.
(Note: The adverse reactions of montelukast have also been worsened over the years. More attention, see: FDA issues new black box warning for montelukast, can we still use it?)
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4. Can children take chlorpheniramine (chlorpheniramine maleate tablets) for urticaria in children? Will there be side effects?
Antihistamines are common medications used to treat urticaria, including first-generation antihistamines ( Chlorpheniramine maleate tablets, promethazine, diphenhydramine, ketotifen, etc.) and second-generation antihistamines (loratadine, cetirizine, etc.).
Chlorpheniramine Maleate Tablets is a first-generation antihistamine with significant anticholinergic effects and central nervous system Sedative effects, such as causing drowsiness, and may interact with alcohol and many other drugs to affect cognition and performance. Second-generation antiallergic drugs have weak or no sedative effects and no anticholinergic effects.
In fact, first-generation antihistamines have more side effects than second-generation antihistamines, now Guidelines have advised against the use of first-generation antihistamines as first-line treatment for urticaria in adults and children, especially children, except in the few areas where second-generation antihistamines are not available. Australia’s Therapeutic Goods Administration (TGA) also issued a safety notification in 2018, reminding that first-generation oral sedative antihistamines are not approved for use in children under 2 years of age. The first-line option for children with urticaria is non-sedative second-generation antihistamines, and the long-term safety of these drugs in children has also been proven.
5, during chronic urticaria treatment, can you get vaccinated?
In the stable period of chronic urticaria, it is possible to take preventive injections, but it is not recommended in the acute attack. period to fight.
Some children have chronic urticaria for a long time and will take medicine for several months. During this period, if the patient is well controlled, there is no In case of seizures, it is possible to get vaccinated. Antihistamines have little effect on the efficacy of vaccines. Even some special vaccines will take anti-allergic drugs orally before injection to prevent the occurrence of allergies.
However, if the body is in a stage of immune disorder during the onset of urticaria, a variety of cells, especially mast cells, are in the stage of activation. At this time, if a vaccine is injected, an exogenous antigen stimulates the body, and mast cells may release more inflammatory factors, causing a more intense allergic reaction.
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This article was first published on “Yihe Science”. More reliable health science.