Chronic Hives-negative blood work

I first got the hives three years ago after my first flu shot but did not make the connection. The itching was all over but no rash so doc thought I was crazy. The second year, second flu shot - hives were big white bumps and itching. The third year, third flu shot - hives broke out head to foot and were vicious with a couple of blood blisters and red bumps and swaths of red here and there and horrible itching sometimes feels like picking with fine needles when it starts. It's been hell. I have to take so many meds to keep them down. Does not even stop them completely. No idea how I'm going to get rid of the mercury. I looked online and picked up cilantro and some other foods they say. Waiting to hear what my doctor says.

How many xolair shots have you gotten?? I have had four and i still get hives.. I was told to continue my antihistamines , did you do that also.. thanks Jana

Hey Jana94738,

I've been getting Xolaire shots (9 or 10 now) since May 2017, and I don't think it's doing a darn thing. I also take Plaquenil, doxepin, hydroxyzine, ranitidine, certrizine and levocertrizine, allegra and montelukast, and prednisone. My allergist said that while I'm still on the prednisone taper, I should continue to take Xolaire. I am in the drug maker's $5 co-pay program so the drugs are affordable. My body is doing everything it can to break out in hives and as far as I can tell, I can get hives immediately or delayed from multiple products (food, preservatives, additives, and fragrances). We think, it started from taking daily and as needed aspirin for cardiac protection and pain relief (it worked well for my aches and pains) for years. I stopped it months ago, but once the body starts down this allergic path, it's difficult to stop. I hope this year is better; I plan to keep the prednisone side effects down through diet and exercise.

Yes, I have an epi pen b/c it's required when taking Xolair. Hang tough

no one said i needed one.. but i could get one if i wanted it.. why do you have to have an epi pen when on xolair

Hopefully you researched the need for an Epipen w/Xolair online. I cut & pasted the following from an Expert physician response, Dennis K. Ledford, MD, FAAAAI, on The AMERICAN ACADEMY of Allergy Asthma & Immunology website.

“Patients should remain in the physician’s office/medical clinic for at least 30 minutes after receiving an injection, but longer waits are reasonable, as directed by the physician. Some physicians might request that patients considered at increased risk of a serious systemic reaction outside of the office/medical clinic carry injectable epinephrine. These patients should be instructed in the use of epinephrine to treat a systemic reaction that occurs after they have left the physician’s office or other location where the injection was given. The risks and benefits of continuing allergen immunotherapy in patients who have had a severe systemic reaction should be carefully considered.”

“Summary Statement 36: Several large studies demonstrate that life-threatening anaphylactic reactions after the first 30 minutes are rare. Delayed and biphasic immunotherapy-induced systemic reactions can occur outside of a supervised medical facility. Thus patients should be educated regarding the possible signs and symptoms of systemic reactions and to contact their health care professional or seek emergency medical attention, as indicated. The decision to prescribe epinephrine autoinjectors to patients receiving allergen immunotherapy is up to the physician’s discretion and is based on a number of considerations. C At the onset of immunotherapy, patients should be counseled on the possibility of immediate and delayed systemic reactions during risk communication; an action plan for such an event should be discussed. In the event of a delayed systemic reaction, the patient should be counseled on appropriate treatment based on their symptoms. They should be instructed to contact their health care professional or seek emergency medical attention, as indicated. After a delayed systemic reaction, the physician should evaluate the risks and benefits of continuing immunotherapy; consider some treatment modifications, such as a longer wait period; or both. The length of the longer wait time will depend on the clinical history of the delayed systemic reaction. Physicians might also want to consider prescribing an epinephrine autoinjector to treat such future reactions”.

The task force report in 2007 was a result of reports of anaphylaxis and limited experience at the time. I think the delayed reactions, the greater risk of anaphylaxis in subjects with persistent asthma and the limited experience with omalizumab at the time lead to cautious recommendations. However, the report in 2007 provides latitude for physician judgment (Cox L, Platts-Mills TAE, Finegold I et al. American Academy of Allergy, Asthma and Immunology/American College of Allergy, Asthma and Immunology Joint Task Force Report on omalizumab-associated anaphylaxis. J Allergy Clin Immunol 2007;120:1373-77):

Hi again,

I've never used an Epipen for any reason, and chronic urticaria is not considered life-threatening. It's used in the rare instance of anaphylaxis or trouble breathing particularly in an asthmatic patients status post treatment with Xolair. It's a safety/emergency drug only, and it requires the person to go to an ED or call 911 immediately after use.