Bone pain after granulocyte–colony-stimulating factors continues to be a problem and appears to be more pronounced with higher doses used in stem cell transplant settings. Beyond medicating for pain, some practices have found great success with cetirizine hydrochloride (Zyrtec® , Pfizer, Inc., New York, NY) 20 mg orally per day in relieving pain. The effect is believed to be achieved through the anti-inflammatory response. If shoulder pain occurs, a rare side effect of splenic rupture should be ruled out. This appears at the web site:
http://onsopcontent.ons.org/Publications/SIGNewsletters/chemo/chemo18.1.html
