Acetaminophen and diphenhydramine as premedication for platelet transfusions: A prospective randomized double‐blind placebo‐controlled trial

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Abstract
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. Am. J. Hematol. 70:191–194, 2002.