H2-antihistamines for the treatment of anaphylaxis with and without shock: a systematic review

Ann Allergy Asthma Immunol. 2014 Feb;112(2):126-31. doi: 10.1016/j.anai.2013.11.010. Epub 2013 Dec 5.


Background: Anaphylaxis is a serious allergic or hypersensitivity reaction, which is rapid in onset and sometimes can prove fatal. Although H2-antihistamines are often administered for emergency treatment in anaphylaxis, there is uncertainty about their effectiveness in this disease.

Objective: To assess the benefits and harms of H2-antihistamines in the treatment of anaphylaxis.

Methods: A systematic review was performed of randomized controlled trials and quasi-randomized controlled trials comparing H2-antihistamines with placebo or no intervention in patients with anaphylaxis.

Results: The authors failed to identify any eligible studies for inclusion in this systematic review.

Conclusion: When H2-antihistamines are recommended for anaphylaxis treatment, the status of the evidence base supporting their use should be described. Well-designed randomized controlled trials investigating the role of H2-antihistamines in anaphylaxis treatment are urgently needed.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anaphylaxis / complications
  • Anaphylaxis / drug therapy*
  • Anti-Allergic Agents / therapeutic use*
  • Epinephrine / therapeutic use
  • Evidence-Based Medicine / methods
  • Evidence-Based Medicine / standards
  • Histamine H1 Antagonists / standards
  • Histamine H1 Antagonists / therapeutic use
  • Histamine H2 Antagonists / therapeutic use*
  • Humans
  • Practice Guidelines as Topic / standards
  • Randomized Controlled Trials as Topic / methods
  • Randomized Controlled Trials as Topic / standards
  • Shock* / complications
  • Shock* / drug therapy


  • Anti-Allergic Agents
  • Histamine H1 Antagonists
  • Histamine H2 Antagonists
  • Epinephrine