What to do if…
you develop hives or facial swelling after eating or taking a medication
Short answer
If you have facial/lip/tongue swelling, throat tightness, trouble breathing, faintness, or you feel rapidly worse: use your adrenaline auto-injector if you have one and call 999 now.
Do not do these things
- Do not “wait and see” if there is facial swelling, voice changes, throat tightness, breathing trouble, dizziness, or symptoms are getting worse.
- Do not take more of the food/medicine “to test it”.
- Do not drive yourself to A&E if you feel unwell, lightheaded, or symptoms are progressing.
- Do not rely on an antihistamine alone if you have facial swelling or any breathing/swallowing symptoms.
- Do not ignore swelling that involves the lips, mouth, tongue, or throat (this can worsen quickly).
- Do not restart the same suspected trigger later “just to check” without medical advice.
What to do now
- Check for emergency “red flags” (treat as an emergency if any apply):
swelling of lips/mouth/tongue/throat, trouble breathing, wheeze, persistent cough, hoarse voice, difficulty swallowing, blue/grey/pale colour, severe tummy symptoms with feeling faint, confusion, collapse, or symptoms spreading fast. - If any red flag is present:
- Use your adrenaline auto-injector immediately if you have been prescribed one (follow the instructions on the device).
- Call 999 for an ambulance and say you think it’s anaphylaxis.
- While help is on the way (if you can do so safely):
- Lie down and raise your legs. If breathing is difficult, raise your shoulders or sit up slowly.
- If you feel sick or might vomit, turn onto your side (recovery position).
- Stay with someone if possible; ask them to watch your breathing and alertness.
- If you have hives/itching only and you’re otherwise well (no facial swelling, no breathing/swallowing symptoms, no faintness):
- Stop the suspected trigger (don’t eat more; don’t take another dose).
- Consider a non-drowsy antihistamine you can safely take (check the packet; a pharmacist can advise if you have other conditions or take other medicines).
- Get urgent advice from NHS 111 if symptoms are spreading, not improving, keep coming back, or you develop any swelling under the skin (possible angioedema).
- If the reaction followed a medication:
- Unless a clinician has told you otherwise, do not take another dose of the suspected medicine until you’ve spoken to a pharmacist or the prescriber (NHS 111 can direct you if you can’t reach them).
- If it’s a medicine you believe you must not stop abruptly (for example, for seizures, heart rhythm, transplant medicines, or steroids), get urgent advice before making a stop/skip decision—and if swelling or breathing symptoms are present, treat it as an emergency and call 999.
- Capture the key details now (takes 60–90 seconds):
- Take a photo of the rash/swelling, note the time symptoms started, and list everything eaten/taken in the previous few hours (including supplements).
- Keep the packaging (food label / blister pack) so ingredients and batch details are available.
- Reduce repeat exposure risk (once you’re stable):
- Ask a pharmacist or your GP practice to record the suspected allergy/adverse reaction in your records and on repeat prescriptions.
- If it was a food, avoid that exact item/brand until you’ve had medical advice, and keep the label.
What can wait
- You do not need to figure out the exact trigger right now.
- You do not need to arrange allergy tests today (that can be done after urgent risk is excluded).
- You do not need to contact the restaurant/manufacturer immediately—keep the packaging and do it later.
- You do not need to decide whether you’ll ever take that medicine/food again today—focus on safety and clear documentation.
Important reassurance
Hives and swelling can feel scary and out of proportion to how you “look” in the mirror. It’s reasonable to feel panicky. Taking the possibility of a serious allergic reaction seriously is not overreacting—getting assessed early is the safer choice.
Scope note
These are first steps only—aimed at staying safe in the moment and avoiding irreversible mistakes. Next steps (like allergy referral, prevention plans, and medication alternatives) come after urgent risk is excluded.
Important note
This is general information, not a diagnosis. If you are unsure whether your symptoms are serious, treat it as urgent and seek medical help immediately.
Additional Resources
- https://www.nhs.uk/conditions/anaphylaxis/
- https://www.nhs.uk/conditions/angioedema/
- https://www.nhs.uk/conditions/hives/
- https://www.gov.uk/drug-safety-update/adrenaline-auto-injectors-aais-new-guidance-and-resources-for-safe-use
- https://yellowcard.mhra.gov.uk/
- https://www.resus.org.uk/sites/default/files/2021-05/Emergency%20Treatment%20of%20Anaphylaxis%20May%202021_0.pdf