What to expect from omalizumab treatment for chronic hives

Omalizumab is given by injection under a clinician's direction. It works by reducing an immune signal involved in hives, so the aim is to lessen wheals and itch rather than treat a simple external trigger. Your clinician will review your symptom pattern and current medicines before each treatment plan is continued. Improvement may be gradual, and symptoms can still appear while the response is being assessed. Keep taking or changing antihistamines only as directed; do not use a disappearing hive as proof that a food or medicine is safe.

Bring a list of medicines, allergies, and previous injection reactions. Track when hives, swelling, and itch occur, including whether they disturb sleep or daily activities. Remain available for the observation period advised by the clinic after an injection. Ask before receiving a dose if you are unwell or have developed a new allergy concern. Learn more in [Omalizumab Treatment](/treatments/medical-dermatology/omalizumab-therapy/).

Seek emergency help for trouble breathing, throat or tongue swelling, faintness, severe dizziness, or a rapidly worsening reaction after an injection. Contact the treatment team promptly for widespread swelling, severe hives, or symptoms that are not controlled by the agreed rescue plan. Never delay urgent care while waiting for the next appointment.

Ask how injections will be scheduled, how long observation lasts, which symptoms should be recorded, and what to do if hives return between visits. Clarify which antihistamine plan remains in place and how an injection reaction would be managed.