OverviewDosageSide EffectsInteractionsHalf-Life

Individuals who have hives for more than 6 weeks that recur for several months or even years are considered to have chronic hives or chronic idiopathic urticaria. Xolair for hives treatment can help ease itchiness and reduce the number of outbreaks.


The dosage for a Xolair (omalizumab) injection for chronic hives is 150 or 300 mg every 4 weeks. The dosage amount does not depend on body weight or serum IgE levels.

Side Effects

Xolair can cause possible side effects in individuals who have chronic hives. Some of the more common side effects that can occur include:

  • Nausea
  • Headaches
  • Joint pain
  • Cough
  • Swelling inside the sinuses, nose, or throat
  • Upper respiratory tract infection

For more information, please see our page on Xolair side effects.


How long does Xolair take to work for hives?

How soon Xolair begins to work for hives can vary from one individual to the next based on different factors. However, a 2018 study showed that the mean time for remission to occur was 9.3 weeks after receiving an injection. Roughly half of the patients in this study experienced remission after receiving one dose.

What does Xolair do for hives?

Xolair is a monoclonal antibody medication that might help prevent IgE from attaching to mast cells (mastocytes, labrocytes), a type of immune cell. IgE attaches to mast cells and causes them to release inflammatory substances called histamines, which results in hives. Xolair binds to IgE, which might make it more difficult for this substance to attach to mast cells. The exact reason why this process might improve chronic hives is not fully understood.

What autoimmune disease causes hives?

Some cases of chronic hives occur due to an overactive immune system; different types of autoimmune diseases have also been associated with chronic hives. Some of these include thyroid disease, Sjögren’s syndrome, rheumatoid arthritis, lupus, and type 1 diabetes.

Is Xolair an antihistamine?

Xolair is not considered an antihistamine, although patients may use it if antihistamines have been ineffective in treating chronic hives.

Can Xolair be given at home?

Xolair injections are given in a healthcare setting rather than at home due to the risk of having a serious and potentially life-threatening allergic reaction known as anaphylaxis. Patients who receive these injections must be monitored afterwards in case anaphylaxis occurs, since this reaction requires immediate treatment.

Disclaimer: this article does not constitute or replace medical advice. If you have an emergency or a serious medical question, please contact a medical professional or call 911 immediately. To see our full medical disclaimer, visit our Terms of Use page.

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