Other treatments and nonrandomised trials

An early case series of five patients with acute urticaria following insect stings reported good therapeutic effects of intravenous cimetidine 300 mg initially followed by 300 mg orally four times daily) after ineffective administration of epinephrine (adrenaline), H1 antagonists and corti-costeroids.11

A further report investigated the effect of flunarizine, a calcium antagonist, in the treatment of acute urticaria. In this uncontrolled trial 20 patients received a single 10 mg sublingual dose of flunarizine. After 3 hours 16 patients had improved, with effects being more pronounced for itching than for reduction of wheals. Four patients remained unresponsive and five other patients reported drowsiness as a major side-effect.12

A Chinese publication describes the therapeutic effect of the added ingredient of Radix angelicae sinesis in 106 patients with acute urticaria. Unfortunately, the lack of an abstract in English makes it difficult to draw conclusions.13

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