5 responses to “Help, “hive” got a rash! – Article 2: Practical tips in the management of chronic spontaneous urticaria (CSU)”

  1. Excellent Information! Thank you.

  2. Does the “4x dose” refer to the total daily dose of the relevant antihistamine? So for cetirizine it would be 40mg daily or 20mg BID?

  3. Hi Sonja Babovic,

    4x refers to the maximum dose that patients could take within 24 hours, with 1x referring to a single tablet dose (the exception is for prescribed Cetirizine which comes in 20 mg tablets (instead of 10 mg per tablet over the counter)).

    As such, 4x would still be 40 mg for Cetirizine. However, it would be 4 tablets for OTC and 2 tablets for Prescribed. Either option is fine to use. We generally use prescribed Cetirizine (rather than OTC Cetirizine) if they have drug coverage.

    For all options, the total daily dosing can be split throughout the day based on patient preference.

  4. As someone who’s experienced CSU I can attest to the negative impact it can have on quality of life. I think it would be great to do a follow up on this to review family physician role in prescribing omalizumab. I think this could be within the scope fo family practice when appointments with allergists are hard to come by.

  5. Do you see any role for H2 receptor antagonists?
    Or montelukast?
    Thank you for this great article!

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