Histamine is recognized as a potent inflammation mediator. To take an antihistamine like loratadine (Claritin) preemptively is a great way to guard against potential inflammatory processes elicited by bisphosphonate treatment. Studies are on going re anti-inflammatory activities of antihistamine drugs via other pathways.

First generation antihistamines such as diphenhydramine (Benadryl) is inferior for this purpose due to 1) shorter duration of action hence needing more frequent dosing 2) readily cross blood brain barrier resulting in undesirable sedating effects.