Amelioration of cytotoxic-induced emesis with high-dose metoclopramide, dexamethasone and lorazepam.
A double-blind randomised controlled trial comparing the antiemetic effects of sublingual lorazepam combined with high-dose, short course metoclopramide (3 mg/kg) infused twice 3 h apart with or without i.v. dexamethasone is reported. Sixty patients receiving a total of 209 cycles of potentially severely emetic cytotoxic chemotherapy were randomised to receive one or other antiemetic regimen. In those receiving platinum-based chemotherapy the addition of dexamethasone was associated with an improvement in freedom from nausea (P less than 0.01) and freedom from vomiting (P less than 0.05). In the non-platinum-based chemotherapy group the addition of dexamethasone led to a reduction in the duration and severity of nausea, and duration of vomiting (P less than 0.05 in each case). Both antiemetic regimens were well tolerated with a low incidence of adverse effects and could be administered easily in an outpatient setting.
Palmer
M C
MC
Colls
B M
BM
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects; D002986:Clinical Trials as Topic; D003907:Dexamethasone / Q000008:administration & dosage*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008140:Lorazepam / Q000008:administration & dosage*; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage*; D011897:Random Allocation; D014839:Vomiting / Q000139:chemically induced* / Q000517:prevention & control
D003907:Dexamethasone; D008787:Metoclopramide; D008140:Lorazepam; D002945:Cisplatin