Pharmacological interventions for the prevention of allergic and febrile non-haemolytic transfusion reactions

NICE Quality and Productivity Case Studies
Queen's University Belfast
Publication date:
28 October 2011


NICE summary of review conclusions

Pre-transfusion medication with paracetamol or hydrocortisone combined with diphenhydramine (not currently used as an antihistamine in the UK) is not supported by sufficient good quality evidence. Consideration could be given to using pre-transfusion medications only within the context of a research or audit project.

The Implications for practice section of the Cochrane review stated:

We found no evidence that pre-transfusion medication prevents non-haemolytic transfusion reactions (NHTR). This applies regardless of the patient’s history of non-haemolytic transfusion reactions and whether or not they were transfused with leukodepleted blood products. This conclusion is based on three trials with moderate risk of bias. Practically, this implies the prescription of pre-transfusion medication is not justified, unless new evidence from a large high quality trial modifies this conclusion.