I've had Chronic Spontaneous Urticaria for 3 years now. And Bilastine is becoming inneffective

I acquired my lovely random hive outbreaks after being prescribed zoloft (sertraline) for depression nearly 3 years ago. it gave me hives along with a whole host of other symptoms which made me quit it after 3 weeks.

The hives persisted. They were bad. I could only take so much prednisone.

Thankfully I found a good doctor that suggested bilastine (blexten, bilactin etc) 20mg. It was a wonder cure. 10mg/day was enough to completely cure the hives. I would sometimes feel the under-the-skin-itch, and in that case would take 10 more mgs and be good.

But 2 days ago i had the worst outbreak I have had since first getting urticaria. Whole body, heat, itchiness that made me wanna run thru one of those automatic car wash brushes lol.

I can double the dose and it has mostly stayed away. But this morning, even after 3x dose yesterday, I am still breaking out. It really sucks.

I know up to 80mg/day is considered safe, but my fear is the med will lose it's efficacy entirely?

Is there another alternative to Bilastine? (I am in Thailand if that matters)

Thanks so much. I'm glad to know this subreddit exists