Is the use of ranitidine required as a pre‐medication to prevent hypersensitivity reactions to paclitaxel?

Abstract The aim of this brief report was to retrospectively compare the severity and incidence of hypersensitivity reactions (HSRs) in patients who received ranitidine and patients who did not receive ranitidine, as part of their pre‐medication prior to paclitaxel. Data was collected for patients receiving paclitaxel‐containing protocols for breast, head and neck, or lung cancers in 2019 and 2020. The data included the pre‐medications administered prior to each paclitaxel dose, the total doses received and whether a HSR event occurred along with its severity. Eighty patients were reviewed receiving a total of 512 paclitaxel doses with 17 HSRs identified in 15 patients. Of the 241 doses in the ranitidine group, 11 HSRs were recorded for nine patients, compared to the 271 doses in the non‐ranitidine group where six HSRs were recorded for six patients. Most of the 512 chemotherapy doses were preceded by dexamethasone (100%) and loratadine (99.6%). Our results show that the incidence of paclitaxel‐related HSRs was not lowered with the addition of ranitidine to dexamethasone and loratadine. Future studies are warranted exploring the use of any H2‐antagonist as part of the pre‐medication regimen with paclitaxel‐containing protocols and their clinical relevance in preventing or minimising HSR incidence and severity.