Table 7 First and second line therapy

I level therapy:

• Elimination of possible eliciting factors

• Non-sedating second generation antihistamines (nsAH)

If symptoms persist after 2 weeks

II level: Updosing of nsAH(X four times)

If symptoms persist after 4 weeks

III level: Add Leukotriene antagonist or change nsAH

If symptoms persist after 1–4 weeks

IV level: Add ciclosporin, H2 Antistamine, Dapsone, Omalizumab

During exacerbation: systemic steroid for 3–7 days in all levels