Centre of Evidence of Dermatology Best practice guidelines

Guidelines chronic spontaneous urticaria Updated on december 2019


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Pregnant women
First-line treatment

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

Second-generation anti-H1 antihistamines
single dose per day

Prefer cetirizine, levocetirizine and desloratadine because there is more pharmacovigilance-related data.

During the first trimester

A second-generation anti-H1 antihistamine with a considerable history of use during pregnancy is to be preferred (cetirizine, levocetirizine, desloratadine as first-line treatment, and fexofenadine as second-line treatment).

After the first trimester

All non-sedating and minimally atropinic (second-generation) anti-H1 antihistamines can be used.

If a first-generation anti-H1 antihistamine is desired in the first trimester, chlorphenamine, dexchlorpheniramine, pheniramine or promethazine may be prescribed, but their use is not recommended at the end of pregnancy because of the risk of sedation and neonatal atropinic adverse effects (tachycardia, abdominal distension, meconium ileus, etc.).

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guidelines for pregnancy, stage 2 second line treatment

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