Effectiveness of levosulpiride versus metoclopramide for nausea and vomiting in advanced cancer patients: a double-blind, randomized, crossover study.
The antiemetic efficacy of levosulpiride (L) was compared to metoclopramide (M) in a double-blind, randomized, crossover study. Thirty patients with advanced cancer, who were no longer receiving antineoplastic therapy, were randomly assigned to receive either L 75 mg/day or M 30 mg/day. After 7 days, patients were crossed over to the alternate treatment, which was also given for 7 days. The hours with nausea were 1.08 (mean value/day/patient) during treatment with L and 2.01 with M (P = 0.002), independent of the order of administration. The nausea intensity was 0.76 (mean value/day/patient) with L and 1.42 with M (P = 0.0004). Complete control of nausea was obtained in 84.6% of patients receiving L and 42.3% of those treated with M (P = 0.0034). The number of vomiting episodes was 0.38 (mean value/day/patient) during treatment with L and 0.70 with M (P = 0.002), independent of the order of administration. Vomiting disappeared in 81.5% of patients receiving L and 51.8% of those treated with M (P = 0.041). There was a carry-over effect in favor of L. These data indicate that both L and M reduce nausea and vomiting, but L is more effective.
Palliative Care Unit, Vittore Buzzi Hospital, Milan, Italy.
O
O
Corli
A
A
Cozzolino
L
L
Battaiotto
D000368:Aged; D000932:Antiemetics / Q000627:therapeutic use*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D013469:Sulpiride / Q000031:analogs & derivatives* / Q000627:therapeutic use
D000932:Antiemetics; D005765:Gastrointestinal Agents; D013469:Sulpiride; C078143:levosulpiride; D008787:Metoclopramide