A randomized trial of high dose bolus metoclopramide versus low-dose continuous infusion metoclopramide in the prevention of cisplatin-induced emesis.
We compared the antiemetic efficacy of metoclopramide in a bolus low-dose infusion schedule to that of metoclopramide given in a conventional high-dose bolus schedule in a randomized crossover trial. Thirty-two treatment courses in 16 patients receiving cisplatin chemotherapy were evaluable. The metoclopramide regimen was either 2 mg/kg i.v. bolus, then 20 mg/h by infusion for 4 h, or 2 mg/kg i.v. bolus every 2 h for three doses. Dexamethasone 20 mg i.v. and diphenhydramine 50 mg i.v. were also given. Antiemetic efficacy was assessed by a questionnaire. There were no differences in antiemetic efficacy between the metoclopramide regimens. With either program, 75% of patients were emesis-free, 13% had mild symptoms, and 13% had moderate symptoms (greater than two emetic episodes). The infusion metoclopramide regimen was 30% less expensive than the bolus schedule in our pharmacy. Thus, we recommend low-dose metoclopramide infusion as a less expensive, equally effective alternative to high-dose bolus regimens for antiemetic treatment.
Dana
B W
BW
McDermott
M
M
Everts
E
E
Abdulhay
G
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects*; D002986:Clinical Trials as Topic; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008787:Metoclopramide / Q000008:administration & dosage*; D008875:Middle Aged; D011897:Random Allocation; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
D008787:Metoclopramide; D002945:Cisplatin