What to know about Pepcid for hives

Hives, also known as urticaria, are skin reactions that can occur due to certain food or medication allergies. They can result in raised bumps or welts on the skin that are red and itchy.

While hives may result from an allergic reaction, identifying the exact cause of hives poses a challenge. This is because it’s not always clear how the condition began.

Hives are usually temporary and may go away on their own. But antihistamine medications such as Pepcid (famotidine) can help ease symptoms.

Can Pepcid be used for hives?

Although famotidine (Pepcid) is approved for heartburn and other digestive issues, it may be a safe and effective option for helping to reduce chronic (long-term) hives if other treatments don’t clear them up. Because Pepcid isn’t approved for treating hives, this is an off-label use. (Off-label use is when doctors prescribe a drug for a purpose other than what it’s approved for.

What types of allergies can cause hives?

“Hives are a type of immune reaction that develops very quickly. The most common allergic triggers of hives are medication and food allergies,” said Blair Murphy-Rose, MD, a board certified dermatologist based in New York.

Common medications that may cause hives include:

• nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Caldolor)
• antibiotics such as amoxicillin (Amoxil) and ampicillin
• sulfonylureas (a group of medications used to treat type 2 diabetes) such as glyburide (Glynase), glimepiride (Amaryl), and glipizide (Glucotrol)

Various other factors can also cause your body’s immune system to overreact and result in hives, including:

• airborne allergens, such as pollen, animal dander, dust mites, and mold
• contact allergens, such as saliva from cats or dogs
• infections
• insect bites and stings
• heat or sunlight
• pressure or rubbing from clothing
• vibratory urticaria, where the skin is exposed to repetitive friction from vibrations, such as a bumpy car ride

But, in some cases, hives may be one part of a bigger immune response. “Hives associated with other symptoms, such as wheezing, decreased blood pressure, diarrhea, vomiting, abdominal pain or dizziness, could be due to anaphylaxis,” said Marks-Cogan.

If you think you’re experiencing anaphylaxis, it’s important to seek medical help immediately.

What are chronic hives?

“When hives last longer than 6 weeks, they’re considered chronic,” said Murphy-Rose.

“An autoimmune condition or physical stimulus is the most common cause of chronic hives. Very often, the cause is idiopathic, meaning the trigger is unknown,” she said.

To find the cause of your hives, doctors may consider your medical history and run some tests.

How are hives typically treated?

Doctors typically recommend a combination of medication and home remedies to help treat hives.

Medications

Typically, the most common medications for the treatment of hives usually include:

• hydrocortisone topical creams, such as Cortef
• over-the-counter (OTC) allergy medications, such as cetirizine (Zyrtec), levocetirizine (Xyzal), fexofenadine (Allegra) and loratadine (Claritin)
• histamine type 2 receptor blockers, such as cimetidine (Tagamet HB)
• steroids for chronic hives, such as prednisone (Prelone) and methylprednisolone (Medrol)

As already mentioned, famotidine, the generic name for Pepcid, may be given in combination with these medications to help clear up hives.

“If you have chronic hives that aren’t responding to the above treatments, a doctor may consider prescribing a biologic medication such as omalizumab (Xolair),” said Katie Marks-Cogan, MD, a board certified allergist who practices in Los Angeles.

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Home remedies

Home remedies that may help include:

• covering the rash with a cool washcloth to help soothe any itching
• wearing loose clothing
• applying aloe vera gel to the area
• avoiding fragranced beauty products

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Can hives be a sign of something more serious?

In rare cases, hives could be a sign of a serious illness. Marks-Cogan pointed to the following underlying conditions that could cause hives:

• Hashimoto thyroiditis
• rheumatoid arthritis
• systemic lupus erythematosus
• vasculitis (blood vessel inflammation)
• Sjögren disease
• celiac disease

If your hives don’t go away after 6 weeks, it’s important to speak with a doctor. You may want to rule out the possibility of a more serious condition.

How long do hives from an allergic reaction last?

It’s difficult to predict how long hives will last because it’s different for everyone. According to a 2023 research review, hives may last minutes, or they could occur again for months or even years.

Short-term (acute) episodes of hives typically last up to 6 weeks. If your reaction lasts longer than this, it may indicate long-term (chronic) hives.

“That said, sometimes new hives emerge as quickly as the old ones disappear,” explained Marks-Cogan. This is why it’s important to identify the cause to avoid exposing yourself to the trigger again.

Summary

When it comes to treating hives, doctors typically recommend a combination of medication and home remedies. One option for chronic (long-term) hives is Pepcid, also known by its generic name famotidine. It can be used off-label as an alternative medication for chronic hives or in combination with antihistamines.

If you’re still experiencing hives after 6 weeks, it’s important to speak with a doctor to rule out any underlying conditions.