RT Journal Article SR Electronic T1 High-dose antihistamines for chronic spontaneous urticaria in adults JF Drug and Therapeutics Bulletin JO Drug Ther Bull FD BMJ Publishing Group Ltd SP 45 OP 48 DO 10.1136/dtb.2018.4.0614 VO 56 IS 4 YR 2018 UL http://dtb.bmj.com/content/56/4/45.abstract AB Chronic spontaneous urticaria (CSU) is a common skin disease characterised by intermittent weals (hives), angioedema or both lasting for at least 6 weeks.1-3 Second-generation antihistamines are widely used to manage symptoms but are not completely effective in many patients at licensed doses.4 Some guidelines recommend off-label use of high-dose antihistamines as the next therapeutic step.2,3 Here, we review the evidence supporting this recommendation.