1. Symptoms Improve at First but Return a Short Time Later
It’s possible the medication is working, but symptoms are being retriggered by lifestyle habits, which include drinking alcohol, being exposed to heat, or taking nonsteroidal anti-inflammatory drugs (ibuprofen, for example).
On the other hand, if symptoms such as intense itching and swelling keep returning, it may mean the medication isn’t working as well as it used to for you. Either way, it’s a good idea to let your doctor know.
2. Symptoms Aren’t Improving or Are Getting Worse
If you still have itching and skin irritation, despite taking a medication or two, that’s a sign you may need to switch treatments.
3. You Rely Too Much on ‘As Needed’ Medications
It’s not uncommon to have to supplement treatment with an occasional dose of another antihistamine. But if you’re relying on these as-needed medications to control hives, that’s a possible sign that the current treatment regimen you’re following isn’t very effective, says Dr. Codispoti.
4. You Have Side Effects From the Medication
Some medications for chronic hives can cause side effects, such as drowsiness, that can have a major impact on your quality of life. If that’s the case, you may need a different medication. “We want [you] to live a full life,” Codispoti says.
5. You Have Trouble Taking Medication Regularly
Remembering to take medication isn’t easy, especially if you need to take several doses a day. But missing doses can make the medication less effective.
If your schedule is too arduous, ask your doctor if you can take a different medication with a simpler dosing schedule. You can also ask them or your pharmacist for tips on remembering to take medication, such as using a pillbox or leaving a sticky note on your bathroom mirror or fridge.
6. The Medication Is Too Expensive
If you can no longer afford a medication, let your healthcare provider know. They may be able to recommend a generic form of the drug (which tends to be less expensive than the brand name) or a different drug that doesn’t cost as much.
Depending on which medication you take, you may qualify for patient assistance programs or copay savings cards that can lower your costs. Ask your pharmacist whether the medication qualifies for one of these programs.
You can also reach out to nonprofit programs, such as NeedyMeds, Professional Prescription Advice, and RxAssist, to help you cover medication costs.
7. You Had Symptoms That Required Emergency Treatment
If you recently visited an urgent care facility or emergency room for a hives flare or experienced lip or tongue swelling or difficulty breathing, this is a strong indication that the treatment you’re currently on isn’t helping enough.
8. You Were Recently Diagnosed With a New Health Condition or Started a New Medication
Getting a new diagnosis or starting a new medication can affect how well the hives medication you’re currently taking works. You may also be at risk for new drug interactions. Talk to your healthcare provider, who can adjust the medication plan to keep you safe.
Should You Consider Changing Treatments for Chronic Hives?
Do you have new or worsening symptoms?
- A. Yes
- B. No
3 Treatment Changes Your Doctor May Recommend
If symptoms are flaring up, your healthcare provider may want to:
- Increase the medication dosage. Say you’re currently taking an antihistamine. Instead of switching medications, your doctor may recommend taking a higher dose and seeing if symptoms subside.
- Add another medication. If symptoms still aren’t well controlled, your doctor may add a second or third treatment, such as an injection, to your current regimen.
- Switch to a different medication. If the current medication isn’t working well, your doctor may recommend stopping it and switching to a new treatment entirely. They may recommend another type of antihistamine, for example, or a medication from a different drug class.
9 Things to Tell Your Doctor at Your Next Appointment
- Whether your symptoms are getting better or worse
- How often your symptoms are interfering with your daily life
- How often your symptoms are keeping you awake at night
- Whether you’re using an as-needed medication for hives more often than usual
- Whether you’re able to take the medication as directed
- Whether you’re experiencing side effects from medication
- Whether you’re having trouble affording treatment
- If you’ve been recently diagnosed with a new health condition or started a new medication
- Whether you’ve recently been to an urgent care facility or emergency room for chronic hives
Stephen H. Kimura, MD
Medical Reviewer
Stephen Kimura, MD, is a board-certified allergist and immunologist. He's been in private practice in Pensacola, Florida, for the past 25 years with the Medical Center Clinic, a multi-specialty practice. He enjoys working with people who were seen as patients as children and now are bringing their children to him for care.
Dr. Kimura received his medical degree from the University of Kansas School of Medicine. He went on to complete his residency at Butterworth Hospital in Grand Rapids, Michigan, and later received additional training in allergy and immunology during his fellowship at the University of Kansas.
Kimura grew up in Hawaii, and says he has many happy memories of coming home from school to go surfing, snorkeling, and swimming at the beaches there.
Amy Gragnolati, PharmD, BCPS
Author
Amy Gragnolati, PharmD, BCPS, is a clinical pharmacist and medical writer. She is board certified in pharmacotherapy and holds her pharmacist license in Georgia and California.
After completing her education at the University of Georgia, she worked as a clinical pharmacist at the University of California San Francisco Benioff Children’s Hospital, specializing in pediatric intensive care, oncology, and cardiac care. She then worked at Kaiser Permanente San Francisco in addiction medicine and adult family medicine. After five years at Kaiser, she worked as a pharmacy editor at GoodRx for four years.
Outside of work, Amy enjoys yoga and has her registered yoga teacher certification. She’s also an avid baker and cook, and loves hosting friends and family for a big meal. On weekends, you can typically find her outside enjoying nature with her husband and kids.