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Diagnosing Chronic Idiopathic Urticaria (CIU)

Primary care physicians and specialists can diagnose and treat CIU

An allergist is a specialist trained to diagnose, treat and manage allergic diseases that can affect different parts of the body.

A dermatologist is a specialist who treats diseases of the skin.

Your doctor and these specialists could help you:

  • Get diagnosed with chronic idiopathic urticaria
  • Find out about CIU treatment options that may be right for you

Locate a doctor near you

An important part of getting diagnosed and treated for CIU is finding a doctor who can help. Find a specialist near you by city or zip code.



Use the Physician Locator

Diagnosing CIU begins with a physical exam and your medical history.

Your doctor will diagnose your condition after examining you and reviewing your medical history. At your doctor's appointment, be ready to answer the following questions.

  • When did your hives start?
  • How often do you have flares?
  • Where do your hives usually show up on your body?
  • Have you been sick or had an infection lately?
  • Are you taking any medications?
  • Does anyone in your family have hives or an autoimmune disease?

After you share your answers and describe your symptoms, your primary care doctor or specialist will take a look at your hives. Then he or she may order one or more tests. These may include a:

  • Blood test - A blood sample may be taken to count the different parts of your blood, like white blood cells and red blood cells. This may be done to rule out infection as the cause of your hives.
  • Skin test - Your skin may be pricked to confirm whether you have allergies.

These tests and more may be done to rule out any other health conditions that could be causing your symptoms.

If a cause still isn't found, your doctor may diagnose you with CIU.

Getting a diagnosis of CIU

Learning that you have CIU may be difficult to accept. Especially when you've been searching for a cause and hoping for an answer, only to find out there is none. If this has happened to you, it may help to know other people are living with CIU.

Visit our YouTube channel to learn more about CIU from doctors and real patients.



Go now

If you have CIU and your symptoms are uncontrolled by H1 antihistamine treatment, it may also help to keep a list of questions to ask your doctor about CIU and XOLAIR. You can download this Doctor Discussion Guide and bring it with you to your doctor visits.

Before you see the doctor, prepare with pictures.

How your CIU symptoms affect you is important. Make notes of where hives have shown up on your body, how many hives you have, and how much they itch. Remember too that hives can move around from hour to hour – they may even disappear. It's a good idea to take photos of your hives at different times during your flares so your doctor can get a complete view of your symptoms.

To track and share all these details with your doctor
download the CIU Tracker mobile app now.

What is XOLAIR?

XOLAIR® (omalizumab) for subcutaneous use is an injectable prescription medicine used to treat adults and children 12 years of age and older with chronic idiopathic urticaria (CIU; chronic hives without a known cause) who continue to have hives that are not controlled by H1 antihistamine treatment.

XOLAIR is not used to treat other forms of urticaria.


What is the most important information I should know about XOLAIR?

Severe allergic reaction. A severe allergic reaction called anaphylaxis can happen when you receive XOLAIR. The reaction can occur after the first dose, or after many doses. It may also occur right after a XOLAIR injection or days later. Anaphylaxis is a life-threatening condition and can lead to death. Go to the nearest emergency room right away if you have any of these symptoms of an allergic reaction:

  • wheezing, shortness of breath, cough, chest tightness, or trouble breathing
  • low blood pressure, dizziness, fainting, rapid or weak heartbeat, anxiety, or feeling of "impending doom"
  • flushing, itching, hives, or feeling warm
  • swelling of the throat or tongue, throat tightness, hoarse voice, or trouble swallowing

Your healthcare provider will monitor you closely for symptoms of an allergic reaction while you are receiving XOLAIR and for a period of time after your injection. Your healthcare provider should talk to you about getting medical treatment if you have symptoms of an allergic reaction after leaving the healthcare provider's office or treatment center.

Do not receive XOLAIR if you are allergic to omalizumab or any of the ingredients in XOLAIR.

Before receiving XOLAIR, tell your healthcare provider about all of your medical conditions, including if you:

  • have ever had a severe allergic reaction called anaphylaxis
  • have or have had a parasitic infection
  • have or have had cancer
  • are pregnant or plan to become pregnant. It is not known if XOLAIR may harm your unborn baby.
  • are breastfeeding or plan to breastfeed. It is not known if XOLAIR passes into your breast milk. Talk with your healthcare provider about the best way to feed your baby while you receive XOLAIR.

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, or herbal supplements.

How should I receive XOLAIR?

  • XOLAIR should be given by your healthcare provider, in a healthcare setting.
  • XOLAIR is given in 1 or more injections under the skin (subcutaneous), 1 time every 4 weeks.
  • In patients with chronic hives, a blood test is not necessary to determine the dose or dosing frequency.
  • Do not decrease or stop taking any of your other hive medicine unless your healthcare providers tell you to.
  • You may not see improvement in your symptoms right away after XOLAIR treatment.

What are the possible side effects of XOLAIR?
XOLAIR may cause serious side effects, including:

  • See, "What is the most important information I should know about XOLAIR" regarding the risk of anaphylaxis.
  • Cancer. Cases of cancer were observed in some people who received XOLAIR.
  • Fever, muscle aches, and rash. Some people who take XOLAIR get these symptoms 1 to 5 days after receiving a XOLAIR injection. If you have any of these symptoms, tell your healthcare provider.
  • Parasitic infection. Some people who are at a high risk for parasite (worm) infections, get a parasite infection after receiving XOLAIR. Your healthcare provider can test your stool to check if you have a parasite infection.
  • Heart and circulation problems. Some people who receive XOLAIR have had chest pain, heart attack, blood clots in the lungs or legs, or temporary symptoms of weakness on one side of the body, slurred speech, or altered vision. It is not known whether this is caused by XOLAIR.

The most common side effects of XOLAIR:

  • In people with chronic idiopathic urticaria: nausea, headaches, swelling of the inside of your nose, throat or sinuses, cough, joint pain, and upper respiratory tract infection.

These are not all the possible side effects of XOLAIR. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at (800) FDA-1088 or You may also report side effects to Genentech at (888) 835-2555 or Novartis Pharmaceuticals Corporation at 888-669-6682.

Please see full Prescribing Information, including Medication Guide for additional Important Safety Information.

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