Sleep disturbance associated with urticaria
Sedating antihistamines are sometimes used at night for sleep disturbance associated with urticaria; however, they are not routinely recommended, particularly in young children, in whom the risk of respiratory depression, paradoxical excitation, irritability, hyperactivity and hallucinations is increased.
For sleep disturbance associated with urticaria in adults or older children, consider short-term use of:
1cyproheptadine 4 mg (adult) orally, once daily at night cyproheptadine cyproheptadine cyproheptadine
OR
1dexchlorpheniramine 2 mg (child 7 to 12 years: 1 mg) orally, once daily at night dexchlorpheniramine dexchlorpheniramine dexchlorpheniramine
OR
1promethazine 10 to 25 mg (child 6 to 12 years: 0.5 mg/kg up to 25 mg) orally, once daily at night1. promethazine promethazine promethazine
Avoid long-term use of sedating antihistamines. If sedating antihistamines are being used for more than a few days, seek specialist advice or referral.
Warn patients (especially those who drive or operate heavy machinery) that sedating antihistamines taken at night can cause drowsiness the following day.
Doxepin is also sometimes used for sleep disturbance associated with urticaria.
The sedating effect of sedating antihistamines and doxepin may wear off with continued use.