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What medication is most effective for initial treatment of urticaria?

Nov 19, 2025 Source: Cainiu Health
Dr. Liu Wenmin
Introduction
There is usually no such thing as a "most effective medication." Drugs commonly used for initial treatment of urticaria include loratadine tablets, cetirizine tablets, ebastine tablets, calamine lotion, and desonide cream. Loratadine tablets: belong to second-generation antihistamines, which can rapidly relieve symptoms such as skin itching and hives, have a quick onset of action, and cause fewer side effects, making them suitable for most patients with early-stage urticaria.

Generally, there is no such thing as a "most effective medication." Medications commonly used in the early stages of urticaria include loratadine tablets, cetirizine tablets, ebastine tablets, calamine lotion, and desonide cream. The details are as follows:

1. Loratadine tablets: A second-generation antihistamine that can quickly relieve symptoms such as skin itching and hives. It acts rapidly and has fewer side effects, making it suitable for most patients with early-stage urticaria. Alcohol should be avoided during treatment to reduce risks of drowsiness and other discomforts.

2. Cetirizine tablets: Also a second-generation antihistamine with clear efficacy in relieving itching and hives. Some patients may experience mild drowsiness after taking it; therefore, it is recommended to take before bedtime. It is suitable for early-stage urticaria patients whose itching affects sleep. Children can also use appropriate formulations under medical supervision.

3. Ebastine tablets: Offers long-lasting antihistamine effects and effectively inhibits histamine release, reducing skin allergic reactions. It provides good control over the spread of hives in early-stage urticaria and rarely causes drowsiness, making it ideal for patients who need to maintain normal work or study routines.

4. Calamine lotion: A topical anti-itch medication with mild, non-irritating ingredients. When applied to affected areas, it quickly relieves itching and helps dry the skin and reduce exudation. It is suitable for cases with multiple hives but no skin breakdown in the early stage of urticaria. It can be reapplied multiple times without interfering with daily activities.

5. Desonide cream: A low-potency corticosteroid ointment suitable for early-stage urticaria with significant itching or limited hive distribution. It rapidly reduces inflammatory responses and relieves itching. However, prolonged and extensive use should be avoided to prevent side effects such as skin atrophy.

After noticing initial symptoms of urticaria, identifying and avoiding the allergen is essential. If symptoms do not improve with medication or if severe symptoms such as difficulty breathing or abdominal pain occur, immediate medical attention is required.

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