WHEN HYDROMORPHONE IS NOT WORKING, TRY LORATADINE: AN EMERGENCY DEPARTMENT CASE OF LORATADINE AS ABORTIVE THERAPY FOR SEVERE PEGFILGRASTIM-INDUCED BONE PAIN

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 pegfilgrastiminduced 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. (C) 2016 Elsevier Inc. All rights reserved.