What medicine to drink to stop itching? Your guide to oral anti-itch medication

October 9, 2025 •

4 min read

Millions of people experience chronic or acute itching, a condition known as pruritus, which can significantly impact quality of life. This guide explores what medicine to drink to stop itching, including over-the-counter (OTC) and prescription options for various underlying causes.

Quick Summary

This guide discusses various oral medications, from over-the-counter antihistamines to prescription drugs, used to treat itching caused by allergies, eczema, and systemic conditions. The right treatment depends on the underlying cause and severity of the pruritus.

Key Points

Identify the cause: The best medication for itching depends on the underlying trigger, whether it's an allergy, eczema, or a systemic issue.
Choose non-drowsy for daytime: For allergy-related itching during the day, opt for second-generation oral antihistamines like cetirizine (Zyrtec) or loratadine (Claritin).
Try sedating options at night: First-generation antihistamines, such as diphenhydramine (Benadryl), are good for nighttime itching due to their drowsy side effect.
Seek a diagnosis for chronic itch: Persistent or widespread itching that doesn't respond to OTC treatment requires evaluation by a doctor to identify and manage the underlying cause.
Use prescription medications for severe cases: Severe or chronic conditions like eczema, neuropathic itch, or renal pruritus may require prescription oral steroids, antidepressants, or neuroleptics under a doctor's supervision.
Consider safety: Always follow dosage instructions and be aware of potential side effects, especially with sedating medications and long-term use.

Understanding the Cause of Itching (Pruritus)

Before reaching for medicine, it is crucial to identify the source of the itching. Effective treatment depends on addressing the root cause, which can range from simple allergies to complex systemic diseases. Common causes include:

Allergies and Hives (Urticaria): Allergic reactions cause the body to release histamine, triggering symptoms like itching, swelling, and rash.
Skin Conditions: Chronic inflammatory conditions such as eczema (atopic dermatitis) and psoriasis are well-known causes of persistent pruritus.
Dry Skin (Xerosis): Dehydrated skin often leads to a generalized itchiness that can worsen in dry, cold weather.
Systemic Diseases: Underlying medical conditions affecting the liver (cholestasis) or kidneys (uremic pruritus), as well as certain cancers and thyroid issues, can cause widespread itching.
Neuropathic Itching: Damage to nerve fibers can lead to chronic, localized itch sensations, such as in notalgia paresthetica.

For mild, temporary itching, OTC medications may suffice. However, for persistent, severe, or widespread itching, especially when accompanied by other symptoms, a visit to a healthcare provider is essential for a proper diagnosis and treatment plan.

Over-the-Counter (OTC) Oral Medications for Itching

For many common causes of itching, such as allergic reactions or hives, oral antihistamines are the most common and accessible treatment. They work by blocking histamine, the chemical responsible for allergy-related itching.

First-Generation (Sedating) Antihistamines

These older antihistamines are effective but can cause significant drowsiness, making them ideal for nighttime use to help with sleep disruption from itching.

Diphenhydramine (Benadryl): Provides rapid, though short-lived, relief from itching, often with a sedative effect.
Chlorpheniramine (Chlor-Trimeton): Another older option that causes drowsiness and may require more frequent administration.

Second- and Third-Generation (Non-Drowsy) Antihistamines

These newer versions are preferred for daytime use as they are less likely to cause drowsiness.

Cetirizine (Zyrtec): Known for its effectiveness and long-lasting relief.
Loratadine (Claritin): Offers non-drowsy relief for allergy symptoms, including hives.
Fexofenadine (Allegra): Also provides long-lasting relief and is generally considered the least sedating of the second-generation options.
Levocetirizine (Xyzal): A potent, long-acting antihistamine that can provide relief and may be taken at night.

Prescription Oral Medications for Severe or Chronic Itching

When OTC options are ineffective, a doctor may prescribe stronger or more specialized oral medications, particularly for chronic or severe pruritus linked to specific conditions.

Oral Corticosteroids

For severe, widespread inflammatory conditions like eczema or contact dermatitis, a short course of oral steroids can quickly reduce inflammation and itching.

Prednisone: A common oral steroid used for severe outbreaks. However, due to significant side effects, long-term use is not recommended.

Antidepressants with Anti-Itch Effects

Some antidepressants have properties that can help manage chronic itching, especially when it affects sleep.

Mirtazapine (Remeron): A sedative antidepressant that can be particularly useful for nocturnal pruritus.
Sertraline (Zoloft): An SSRI that has shown effectiveness for pruritus associated with liver disease and other conditions.

Neuroleptics

For certain types of persistent or nerve-related itching, these medications may be used.

Gabapentin (Neurontin) and Pregabalin (Lyrica): These are analogs of GABA that can help dampen nerve signals, making them effective for neuropathic itching and pruritus related to chronic kidney disease.

Comparison of Oral Medications for Itching


Medication Class	Best For	Key Considerations	Onset	Duration
First-Generation Antihistamines (Diphenhydramine)	Acute allergies, hives, nocturnal itching	Causes significant drowsiness; not for daytime use	15-30 minutes	4-6 hours
Second/Third-Generation Antihistamines (Cetirizine, Loratadine)	Allergies, chronic hives, daytime relief	Less sedating, preferred for daytime. Cetirizine can still cause some drowsiness	1-2 hours	Up to 24 hours
Oral Corticosteroids (Prednisone)	Severe, widespread inflammatory conditions	Powerful anti-inflammatory but for short-term use only due to side effects	Hours to days	Variable
Antidepressants (Mirtazapine, Sertraline)	Chronic pruritus, especially with sleep issues	Requires a doctor's prescription and often used off-label for itching	Weeks for full effect	Up to 24 hours
Neuroleptics (Gabapentin, Pregabalin)	Neuropathic itching, uremic pruritus	Requires a doctor's prescription. Can cause drowsiness	Weeks for full effect	Up to 24 hours

When to See a Doctor

While OTC options can treat many cases of mild itching, it's important to consult a healthcare provider if:

The itching is severe or affects a large area of your body.
Itching persists for more than two weeks despite home treatment.
You experience other symptoms, such as fatigue, fever, unexplained weight loss, or changes in bowel habits.
The itching is accompanied by visible signs of infection, such as fever or pus-filled blisters.
Your symptoms prevent you from sleeping.
The cause of your itching is not obvious.

Conclusion

Choosing the right medicine to drink to stop itching depends heavily on the underlying cause and severity of the condition. For most temporary, allergy-related itching, non-drowsy oral antihistamines like cetirizine or loratadine are a safe and effective starting point. Sedating antihistamines like diphenhydramine can provide relief for nocturnal itching. However, for chronic, severe, or unexplained pruritus, specialized prescription medications may be necessary after a proper diagnosis from a healthcare professional. Never hesitate to seek medical advice for persistent itching, as it can be a sign of a more serious underlying condition. For further information on conditions like chronic hives, consult authoritative resources such as the Mayo Clinic website.

Frequently Asked Questions

For sudden, mild itching, a first-generation antihistamine like diphenhydramine (Benadryl) can act quickly, often within 15 to 30 minutes. However, it can cause drowsiness, so it is often best used at night.

For daytime relief without significant drowsiness, a second-generation antihistamine such as cetirizine (Zyrtec), loratadine (Claritin), or fexofenadine (Allegra) is recommended.

For itching associated with eczema, a doctor might recommend an oral antihistamine to help relieve allergic components or aid sleep. For severe flares, a short course of oral corticosteroids may be prescribed.

For long-term management of chronic itching, non-drowsy antihistamines are often a first choice and are generally considered safe for daily use under medical guidance. Prescription antidepressants or neuroleptics might also be used long-term under medical supervision for specific conditions.

Nocturnal itching often responds to sedating oral medications. First-generation antihistamines or specific antidepressants like mirtazapine, which also have sedative effects, can be beneficial.

If over-the-counter medication does not provide relief, consult a healthcare provider. You may have a condition that requires a prescription-strength treatment or an alternative approach, such as topical creams or light therapy.

Yes, certain antidepressants like mirtazapine and sertraline have been shown to help relieve chronic itching, particularly in cases linked to underlying conditions like liver disease or nocturnal pruritus.