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  1. Holmes, Jarrod P. MD, FACP
  2. Peguero, Julio A. MD
  3. Garland, R. Campbell DO
  4. North, Janine BS
  5. Young, Stacia PharmD, BCOP, MBA
  6. Brent, Lonnie D. PharmD
  7. Joseph-Ridge, Nancy MD


Pretreatment with antihistamines for the prevention of hypersensitivity infusion reactions is recommended for certain biologics and chemotherapies. Cetirizine is the first injectable second-generation antihistamine recently approved for acute urticaria. A randomized, exploratory phase 2 study evaluated intravenous (IV) cetirizine 10 mg versus IV diphenhydramine 50 mg as pretreatment in patients receiving an anti-CD20 agent or paclitaxel. In the overall population (N = 34) and an elderly subgroup (n = 21), IV cetirizine was as effective as IV diphenhydramine in preventing infusion reactions (primary outcome) and associated with less sedation at all time points, a shorter infusion center stay, and fewer treatment-related adverse events.