Lambertini, M., Del Mastro, L., Bellodi, A., & Pronzato, P. (2014). The five “Ws” for bone pain due to the administration of granulocyte-colony stimulating factors (G-CSFs). Critical Reviews in Oncology/Hematology, 89, 112–128.
There was no real difference between pegfilgrastim and daily GCSFs in terms of incidence of bone pain, and most patients will benefit from the use of NSAIDs to control pain. The authors suggest that patients who do not respond to NSAIDs should consider second-line treatment with antihistamines. The study cites a series of four patients and one case study in which this was effective.
Only one study was cited that evaluated the efficacy of antihistamines in relieving or decreasing bone pain associated with GCSFs from 2005. Main evidence is case reports only.
More studies are needed to evaluate the efficacy of antihistamines versus NSAIDs or acetaminophen in relieving bone pain.