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

TY - JOUR

T1 - When Hydromorphone Is Not Working, Try Loratadine

T2 - An Emergency Department Case of Loratadine as Abortive Therapy for Severe Pegfilgrastim-Induced Bone Pain

AU - Moore, Katherine

AU - Haroz, Rachel

N1 - Publisher Copyright: © 2016 Elsevier Inc.

PY - 2017/2/1

Y1 - 2017/2/1

N2 - Background 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 Report This 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.

AB - Background 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 Report This 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.

UR - https://www.scopus.com/pages/publications/84991279000

UR - https://www.scopus.com/pages/publications/84991279000#tab=citedBy

U2 - 10.1016/j.jemermed.2016.08.018

DO - 10.1016/j.jemermed.2016.08.018

M3 - Article

C2 - 27751704

SN - 0736-4679

VL - 52

SP - e29-e31

JO - Journal of Emergency Medicine

JF - Journal of Emergency Medicine

IS - 2

ER -