Article Text

Download PDFPDF

5PSQ-094 Incidence of hypersensitivity reactions in paclitaxel infusions following the discontinuation of ranitidine
  1. JJ Saiz Molina,
  2. MDC Gonzalez Escribano,
  3. A Perez Facila,
  4. TE De Salinas Muñoz,
  5. C Navarro Camacho,
  6. C Notario Dongil
  1. La Mancha Centro Hospital, Hospital Pharmacy, Alcázar de San Juan, Spain


Background and Importance Current literature supports that the use of H2 antihistamines in paclitaxel-containing regimens is not essential, although publications are scarce.1

Aim and Objectives To determine the incidence of hypersensitivity reactions (HRs) during paclitaxel infusion after the withdrawal of ranitidine from the market.

Material and Methods Observational, retrospective and descriptive study in which patients undergoing chemotherapy with paclitaxel-containing schemes for adjuvant (ABC) and neoadjuvant (NBC) breast cancer, cervical cancer (CC), ovarian (OC) and endometrial (EC) were included. The study period was from 2 February 2022 (cessation of marketing of ranitidine) to 31 August 2023.

HRs were analysed after modification of the premedication protocol, which included the same treatment guidelines, excluding ranitidine.

Variables age, sex, type of neoplasm, line of treatment, treatment schedule, administration time, premedication, HRs and measure adopted.

Data source computerised medical records and electronic prescribing programme.

Results A total of 493 administrations of paclitaxel were infused to 68 patients (100% female) with a median age of 64 years [31–89]. 20% corresponded with ABC, 29% OC, 14% CC, 11% EC and 26% NBC. Sixty-seven percent of patients were first-line.

Six HRs were observed during the first or second cycle. Three (50%) were related to paclitaxel administration, one in ABC (paclitaxel 80 mg/m2 weekly over 1 hour), one in OC (paclitaxel 175 mg/m2 over 3 hours) and one in EC (paclitaxel 175 mg/m2 over 3 hours). The remaining three were related to the administration of carboplatin in patients on OC.

HRs appeared in patients aged 43–67 years. One required discontinuation of treatment, the rest were given premedication the day before the cycle and increased infusion time.

Conclusion and Relevance The use of premedication protocols without H2 antihistamines appears to be a safe practice. Our study has limitations in terms of sample size. However, it is important to know the role of these drugs and it is necessary to involve the pharmacist in the development of hospital protocols to identify patients to benefit from these drugs.

References and/or Acknowledgements 1. Gelderblom H, Zwaveling J. No need for H2-antagonists in premedication regimens for paclitaxel infusions: less is more. Br J Cancer. 2021;124(10):1613–4.

No conflict of interest.

Conflict of Interest No conflict of interest.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.