Non-sedating antihistamines for premedication in ambulatory oncology patients

Background: Antihistamines are commonly used as premedication against anaphylactic events associated with paclitaxel and rituximab. Commonly, intravenous (IV) H₁receptor antihistamines are used. Objective: To report our experience with the use of loratadine, an oral, non-sedating H₁-receptor antihistamine, in ambulatory care patients receiving premedication for either paclitaxel or rituximab. Method: Records of all patients who received loratidine in our ambulatory oncology day treatment centre were reviewed retrospectively. Results: Seventy-one cycles (20 paclitaxel, 51 rituximab) of therapy were administered using loratadine as premedication. One patient who commenced loratadine reverted to IV promethazine following a rash reaction to rituximab. All other patients tolerated therapy well. There were no anaphylactic or infusion-related problems. Conclusion: Loratadine 10 mg is well tolerated in ambulatory care patients receiving premedication for either paclitaxel or rituximab and should be considered in all ambulatory patients requiring an H₁-receptor antihistamine where sedation is not appropriate.