When Hydromorphone Is Not Working, Try Loratadine: An Emergency Department Case of Loratadine as Abortive Therapy for Severe Pegfilgrastim-Induced Bone Pain

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• 作者：Katherine Moore ; MD^&lowast ; ; ; Rachel Haroz ; MD^&lowast ; ; ^&dagger ;
• 关键词：bone pain ; emergency department ; filgrastim ; loratadine ; Neupogen ; Neulasta ; pain control ; pegfilgrastim
• 刊名：The Journal of Emergency Medicine
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：52
• 期：2
• 页码：e29-e31
• 全文大小：107 K
• 卷排序：52

文摘

Intractable bone pain is a notorious adverse effect of granulocyte-colony stimulating factors (G-CSFs), such as pegfilgrastim and filgrastim, which are given to help prevent neutropenia in patients who are undergoing chemotherapy. G-CSF–induced bone pain is surprisingly common and often refractory to treatment with conventional analgesics.Case ReportThis article describes an emergency department case of opiate and nonsteroidal anti-inflammatory drug–resistant pegfilgrastim-induced bone pain that was successfully alleviated with 10 mg of oral loratadine, allowing for discharge home.Why Should an Emergency Physician Be Aware of This?This case suggests that loratadine may be an easy to implement, safe, and effective therapy in the emergency department management of intractable bone pain caused by G-CSF use. Emergency physicians should be aware that loratadine may successfully relieve otherwise intractable G-CSF–induced bone pain and allow for discharge home.