Best Treatment Options for Angioedema

The treatment for angioedema depends on what’s causing it.

There are several different types of angioedema, each of which has a different cause. Angioedema can usually be treated at home, although severe cases may need to be treated in hospital.

A. Allergic and idiopathic angioedema

Allergic angioedema and idiopathic angioedema are usually treated in a similar way.

1. Avoiding triggers

Avoiding particular substances or activities that trigger your symptoms may help reduce your chances of experiencing swelling. For example, if you’re allergic to a certain type of food, it can help to check the ingredients in food you buy and be careful when eating out.

2. Antihistamines and steroid medicine

Your health provider may suggest taking antihistamines to reduce swelling when it occurs. Antihistamines work by blocking the effects of histamine, one of the chemicals responsible for the swelling. Some types can be bought in pharmacies and supermarkets without a prescription.

Some antihistamines can make you feel drowsy. Avoid driving, drinking alcohol or operating dangerous machinery if you experience this. If your symptoms of swelling occur during the day, it’s best to take non-drowsy medicines such as cetirizine and loratadine.

Other side effects of antihistamines can include:

  • headaches
  • a dry mouth
  • a dry nose

If the swelling is severe, your health provider may prescribe a short course of steroid medicine. This is a powerful medicine that’s only used for short periods because it can have troublesome side effects.

3. Adrenaline auto-injectors

If you have a particularly serious allergy, you may be given adrenaline auto-injectors to use if you experience a severe allergic reaction (anaphylaxis).

There are several types of auto-injector, which are used in slightly different ways.

B. Drug-induced angioedema

If a certain medicine you’re taking is thought to be responsible for your angioedema, your doctor will usually advise stopping it. They can prescribe a different medicine for you to take instead. This is usually all that needs to be done. Tell your doctor if your symptoms continue or come back after switching medicine.

C. Hereditary angioedema

Hereditary angioedema cannot be cured, but medicines can help prevent and treat the swelling.

1. Preventing swelling

If you have hereditary angioedema, there are a number of medicines available that may help prevent the swelling, or stop it from happening repeatedly.

They include:

  • plasma kallikrein inhibitors, such as berotralstat and lanadelumab
  • androgenic hormones, such as danazol and oxandrolone

A medicine called tranexamic acid may sometimes be used as an alternative, particularly in children and women. This causes fewer side effects, but may not be as effective in preventing swelling.

2. Treating swelling

The 2 main treatments used to treat swelling caused by hereditary angioedema are:

  • icatibant – a medicine given by injection that blocks the effects of some of the chemicals responsible for the swelling
  • C1 esterase inhibitor replacement – a treatment given by injection that boosts the levels of C1 esterase inhibitor in your blood

Occasionally, C1 esterase inhibitor replacement may also be used shortly before surgery or dental treatment, as it can reduce the risk of these triggering swelling.

You may be given a supply of medicine to keep at home and be taught how to give the injections yourself.