Acetaminophen and diphenhydramine as premedication for platelet transfusions: a prospective randomized double-blind placebo-controlled trial.
Non-hemolytic transfusion reactions (NHTR) occur in up to 30% of patients receiving platelet transfusions. Premedication with acetaminophen and diphenhydramine is a common strategy to prevent NHTR, but its efficacy has not been studied. In this prospective trial, transfusions in patients receiving pre-storage leukocyte-reduced single-donor apheresis platelets (SDP) were randomized to premedication with either acetaminophen 650 mg PO and diphenhydramine 25 mg IV, or placebo. Fifty-one patients received 98 transfusions. Thirteen patients had 15 NHTR: 15.4% (8/52) in the treatment arm and 15.2% (7/46) in the placebo arm. Premedication prior to transfusion of pre-storage leukocyte reduced SDP does not significantly lower the incidence of NHTR as compared to placebo.
Wang
Stephen E
SE
Division of Hematology and Oncology, Department of Internal Medicine, UC Davis School of Medicine, Sacramento, California, USA.
Lara
Primo N
PN
Lee-Ow
Angie
A
Reed
Jeanne
J
Wang
Lori R
LR
Palmer
Patti
P
Tuscano
Joseph M
JM
Richman
Carol M
CM
Beckett
Laurel
L
Wun
Ted
T
D000082:Acetaminophen / Q000627:therapeutic use*; D001787:Blood Group Incompatibility / Q000517:prevention & control*; D004155:Diphenhydramine / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006634:Histamine H1 Antagonists / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010919:Placebos; D017713:Platelet Transfusion; D011292:Premedication; D011446:Prospective Studies
D006634:Histamine H1 Antagonists; D010919:Placebos; D000082:Acetaminophen; D004155:Diphenhydramine