What is the recommended adjuvant therapy for urticaria?

H2 blockers are recommended as adjuvant therapy for urticaria because they can help alleviate symptoms associated with histamine release, contributing to the urticarial response. While first-line treatment for chronic urticaria typically involves H1 antihistamines, adding an H2 blocker can enhance the effectiveness of treatment by providing additional histamine antagonism. This approach is particularly useful in cases where patients do not respond adequately to conventional antihistamines alone.

Corticosteroids are generally reserved for more severe or refractory cases of urticaria, as they can quickly reduce inflammation but are not the first line for routine management. Intravenous fluids may be necessary in cases of anaphylaxis or volume depletion, but they do not address the underlying allergic response causing urticaria. Immunotherapy, while effective for some allergies, is not a standard treatment for urticaria as it does not directly target the acute histaminergic reaction typical of urticaria episodes. The use of H2 blockers in combination with H1 antihistamines can provide a more comprehensive approach to managing the symptoms of urticaria.