Abstract
As a preventive measure against allergic/hypersensitivity reactions due to paclitaxel (PTX),the administration of premedication composed of three components,dexamethasone sodium phosphate injection,diphenhydramine hydrochloride tablet,and ranitidine hydrochloride injection solution (or injectable famotidine),is stipulated in the package insert.In the present study,we used d -chlorpheniramine maleate injection instead of diphenhydramine hydrochloride tablet and examined its effectiveness against PTX-related allergic reactions in 101 patients.
When d -chlorpheniramine maleate injection was given as premedication,the frequency of allergic reactions was 13.9% (14/101),and for those of greater than Grade 3,which are considered to be severe,it was 2.0% (2/101).In addition,the frequencies of allergic reactions in patients with and without an allergic past were 37.5% (6/16)and 9.4% (8/85),respectively,a significant difference (p=0.0087).Although none of the patients with an allergic past had severe allergic reactions (greater than Grade 3),there were severe reactions in 2 (2.4%) patients with no allergic past.Seven of the 101 patients (6.9 %) experienced PTX-related allergic reactions in the first treatment,whereas 1 patient (1.0%) had an allergic reaction in the second treatment.In the 3rd and later treatments,PTX-related allergic reactions occurred in 6 patients (0.6%),though PTX had been administered 992 times to 91 patients.
In conclusion,when d -chlorpheniramine maleate injection was used as premedication,it was equivalent to the conventional premedication as regards preventing allergic/hypersensitivity reactions.However,in patients with no allergic past and those under long-term treatment who had been treated 3 or more times,we consider that d -chlorpheniramine maleate injection was particularly effective in preventing PTX-related allergic reactions.
