Chloropyramine and Ranitidine as a combination of H1 and H2- antihistamines in the additive therapy of anaphylaxis

Introduction: Current international guidelines recommend H1 and H2- antihistamines as a second or third- line drugs for the management of anaphylaxis. Aim: To present positive cardiovascular and dermatological effects of Chloropyramine and Ranitidine as the combination of H1 and H2- antihistamines in additive therapy of anaphylaxis. Patients and methods: In a retrospective study two groups of 146 patients who met the NIAID/FAAN criteria for the diagnosis of anaphylaxis were compared. Experimental group consisted of 62 patients who received combination of Chloropyramine H1- antihistamines and Ranitidine H2- antihistamines. Control group consisted of 84 patients who received only Chloropyramine H1- antihistamines. Results: A statistically significant differences of diastolic pressure and central pulse (p< 0.001), a higher values of diastolic pressure, and a lower values of central pulse in the experimental group of patients were recorded at the end of the prehospital treatment of anaphylaxis. The increase in the mean arterial blood pressure at the end of the treatment is higher in the experimental group compared to the initial values, with an average difference of 15 mmHg (%95 CI= 7,95-21,95). Total prehospital time and time recovery of the skin urticaria and itch was shorter in the experimental group for 18 minutes (95% CI= 11,95-25,95). Conclusion: Positive cardiovascular effects and a faster resolving of the skin symptoms justify the use of combination Chloropyramine and Ranitidine as an additive therapy of anaphylaxis that is not life- threatening, and of a rapid progression.