Medicating for Cold Urticaria

No one medicine that you or a child can take on a daily basis will prevent you from breaking out to cold once you have CU.  As a matter of fact, researchers have found the best outcomes come when mixing two or more (H1 and H2) histamine blockers.  They have also found a marked improvement in reactions when Singulair is combined with at least two antihistamines.  In English, H1 blockers are your everyday antihistamine allergy meds.  H2 blockers are antacids. 

In most studies, they have found that Cyproheptadine (Periactin), Hydroxizine (Atarax) and Montelukast (Singulair) provide the best control on the majority of patients; however, doctors never start out using these meds due to their side effects.  For children, doctors will start with over the counter meds and preferably with non-sedating meds like Claritin and Allegra.  For individuals with more complex reactions and/or are resistant to these meds, doctors start working their way to more powerful meds and those that are sedating. 

Any given combination that works for one person is not guaranteed for another person.  If you don't find what works for you keep working with your doctor to try other combinations.  As a child grows, they will out grow their dosing, so if a med stops working, talk to the doctor and find out if doses can be increased or determine if your child needs a new med.

Also, when a medication causes drowsiness, a doctor will usually suggest you or your child taking it before bed time; however, some will experience the drowsiness at the time of waking up or early in the morning as the medication is wearing off.  You may find moving the time the med is taken to earlier in the day (2 hours earlier) so that the wearing off of the med occurs during the night, the child will feel much better in the morning.

In our experience, no medication and no combination of medications prevents all reactions; however, the difference in what they do prevent is the difference between being functional and non-functional.  Preventing reactions is a multi-tiered approach involving medications, preventative actions in where you go and how you dress and knowing when to just say, "no, I can't do it."