Prophylaxis of delayed nausea and vomiting after cancer chemotherapy.
OBJECTIVE
To compare ondansetron and domperidone for treatment of delayed nausea/vomiting (DN/V) following highly emetogenic chemotherapy, after attaining total suppression of emesis on the day of chemotherapy by mean of ondansetron (combined with dexamethasone in the case of cisplatin-treated patients).


METHODS
Domperidone (3 x 20 mg daily) was compared with ondansetron (3 x 8 mg daily) in a randomized double-bind placebo-controlled study. Out of 65 consecutive patients who received a first course of either cyclophosphamide and cisplatin for advanced stage ovarian cancer or cyclophosphamide, doxorubicin and 5-fluoro-uracil for metastatic breast carcinoma, 60 patients were eligible for entering the study. According to data from the literature these chemotherapeutic regimens with induce DN/V to a comparable degree. The patients were questioned daily from day 2 through day 5 by the same investigator and the severity of nausea or vomiting was scored on a numerical scale.


RESULTS
Emesis was totally suppressed in all patients on the day of chemotherapy. As to DN/V, 16 out of 20 patients receiving placebo required "rescue" medication versus none in the other two groups (p < 0.001). Only 2 (10%) patients were symptomatic with domperidone versus 9 (45%) symptomatic patients in the ondansetron-treated group (p < 0.05).


CONCLUSIONS
Both drugs are effective, but domperidone (3 x 20 mg) is more effective than ondansetron (3 x 8 mg) for the prevention of the delayed nausea and/or vomiting which occur after highly emetogenic chemotherapy (p < 0.05).
Esseboom
E U
EU
Department of Internal Medicine, St Elisabeth Hospital, Curaçao, Netherlands Antilles.
Rojer
R A
RA
Borm
J J
JJ
Statius van Eps
L W
LW
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D002945:Cisplatin / Q000009:adverse effects; D004294:Domperidone / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced / Q000517:prevention & control*; D009369:Neoplasms / Q000188:drug therapy*; D017294:Ondansetron / Q000627:therapeutic use*; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control*
D017294:Ondansetron; D004294:Domperidone; D002945:Cisplatin