To relieve most uncomplicated episodes of hives, your doctor may suggest that you apply calamine lotion and/or take a nonprescription antihistamine medication, such as chlorpheniramine (Chlor-Trimeton), clemastine (Tavist) or diphenhydramine (Benadryl). It is critical to relieve the itching because scratching can stimulate more hives and itching.
If these medications are not effective, you may be given a prescription medication such as cyproheptadine (Periactin), azatadine (Optimine) or hydroxyzine (Atarax or Vistaril). For people who have significant side effects from those medications, non-sedating antihistamines can be used, including loratadine (Claritin), cetirizine (Zyrtec) and fexofenadine (Allegra). For cases that are even more resistant to treatment, H2 receptor blockers might be added. These include ranitidine (Zantac), nizatidine (Axid), famotidine (Pepcid) or cimetidine (Tagamet). Doxepin (Adapin, Sinequan) is particularly helpful for people having a hard time sleeping at night. When other options fail, corticosteroids may be used to suppress the immune system in chronic urticaria or for frequently recurring episodes.