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Can loratadine help in treating granulocyte-colony stimulating factor-induced bone pain?
Shilpa N Gajarawala1, Jessica N Pelkowski, Christopher C DeStephano
1Shilpa N. Gajarawala practices in the Department of Medical and Surgical Gynecology at Mayo Clinic Florida, is an assistant professor in obstetrics and gynecology in the Mayo Clinic College of Medicine, and is an adjunct faculty member for the DMSc program at Rocky Mountain University of Health Science in Provo, Utah. Jessica N. Pelkowski is an NP in the Department of Orthopedic Surgery at Mayo Clinic Florida, and an assistant professor of orthopedic surgery and instructor of nursing in the Mayo Clinic College of Medicine. Christopher C. DeStephano practices in the Department of Medical and Surgical Gynecology at Mayo Clinic Florida and is an assistant professor of obstetrics and gynecology in the Mayo Clinic College of Medicine. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Abstract:
Febrile neutropenia is an oncologic emergency with serious consequences. Granulocyte colony stimulating factors (G-CSFs), used to stimulate neutrophil production to prevent febrile neutropenia, can cause bone pain in more than 25% of patients. Severe bone pain may not respond to acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, or dose reduction of the G-CSF agent. A study found that patients taking loratadine had fewer treatment-associated adverse reactions and discontinuations than those on naproxen. Although more research is needed, loratadine's tolerability, ease of administration, and potential benefit mean that it should be considered for management of pegfilgrastim-associated bone pain. This article describes a patient whose G-CSF-induced bone pain was completely alleviated by loratadine.
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