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Start here for antihistamines

Ask your provider about trying over-the-counter antihistamines, such as ones below. Try a variety to discover which work best for you.

Antihistamine second-generation H1-blockers help with skin symptoms, such as hives or rashes.

  1. Cetirizine, brand name Zyrtec. Try 10mg 2 times per day. If it helps, try increasing to 20mg 2 times per day. If it doesn't help, then discontinue, and try the next step.

  2. Fexofenadine, brand name Allegra. Try 180mg 2 times per day. If it helps, try increasing to 360mg 2 times per day. If it doesn't help, then discontinue, and try the next step.

  3. Loratadine, brand name Claritin. Try 10mg 3 times per day. If it helps, try increasing to 10mg 4 times per a day. If it doesn't help, then discontinue, and try the next step.

  4. Levocetirizine, brand name Xyzal. Try 5mg 2 times per day. If it helps you, then try increasing to 10mg 2 times per day. If it doesn't help, then discontinue, and ask your doctor for help.

Antihistamine second-generation H2-blockers help with gastrointestinal symptoms, such as acid reflux or indigestion.

  1. Famotidine, brand name Pepcid. Try 20mg 2 times per day. If it helps, try increasing to 40mg 2 times per day. If it doesn't help, then discontinue, and try the next step.

  2. Cimetidine, brand name Tagamet. Try 200mg 2 times per day. If it helps, try increasing to 400mg 2 times per day. If it doesn't help, then discontinue, and try the next step.

  3. Ask your doctor about other medications, including proton pump inhibitors (PPIs): esomeprazole (brand name Nexium), lansoprazole (brand name Prevacid), omeprazole (brand name Prilosec).

Antihistamine first-generation for flares or sleep:

  1. Diphenhydramine, brand name Benadryl. Use as needed for flares, or to help with sleep, in addition to the antihistamines above. Caution: this medication has side effects that may include sedation, confusion, dizziness, etc. Try 25mg once. If it helps, try increasing to 50mg once. Can be taken 25-50mg every 5 hours. If it doesn't help, then discontinue.