Centre of Evidence of Dermatology Best practice guidelines

Guidelines chronic spontaneous urticaria Updated on december 2019


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Children < 12 years
Second-line treatment

Back to decision-making tree Print last updated on 18/09/2020

In case of failure with single doses of second-generation anti-H1 antihistamines

Gradually increase the dose of anti-H1 antihistamines up to 4 doses per day.

As a second-line treatment, the WG instead recommends multiple doses of rupatadine (no longer available in oral solution since 2018) or desloratadine; these 2 anti-H1 antihistamines have been studied at double, triple and quadruple doses, with a “demonstration” of efficacy and good tolerance in 46 patients.

Delays vary from 1 week to 1 month between each dose increase in the literature.

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guidelines for children under 12yo, stage 3 third line treatment

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