Your doctor will work with you on a treatment plan that’s suited to your individual needs.
If your symptoms are mild, simple lifestyle changes may be all you need. However, lifestyle modifications can be difficult to adhere to if you’re an athlete or if you engage in physical or strenuous activity in your daily life. Medication may be a better option for some.
One of the simplest ways to manage CU is to modify the way you exercise and to avoid situations that raise your body temperature. Your doctor can advise you on how to best achieve this. Depending on your needs, treatment may involve limiting outdoor exercise during the summer months and learning strategies to manage stress and anxiety.
Antihistamines are the first line of medication your doctor may try to prevent and treat CU. These may include H1 antagonists, such as hydroxyzine (Vistaril) or terfenadine (Seldane), or H2 antagonists, such as cimetidine (Tagamet) or ranitidine (Zantac).
Ranitidine, brand name Zantac, is now marketed as Zantac 360, which contains a different active ingredient (famotidine). Famotidine is in the same class as ranitidine and works the same way but has not been found to contain unacceptable levels of NDMA.
You may also be prescribed a medication to control the amount you sweat, such as methantheline bromide or montelukast (Singulair). Your doctor may also recommend beta blockers, immunosuppressants, or even UV light to treat CU.
If you experience exercise-induced anaphylaxis, your doctor will prescribe an EpiPen to use if symptoms appear. Talk to them about how to use the EpiPen so that you’re prepared if severe symptoms occur. You may also want to have an exercise partner nearby so that they can step in and administer the medication if needed.