Prevention of acute and delayed cisplatin-induced nausea and vomiting with intravenous ondansetron plus intravenous dexamethasone.
BACKGROUND
We conducted a prospective study to evaluate the anti-emetic effect of cisplatin-induced nausea and vomiting with intravenous (i.v.) ondansetron plus i.v. dexamethasone.


METHODS
One hundred forty-six chemotherapy (CT)-naive patients were enrolled in the study. They were scheduled to receive cisplatin 50 to 100 mg/m2 (mean, 53 mg/m2) on day 1 followed immediately by continuous infusion of 5-fluorouracil with or without other CT agents on the subsequent days. Three 8 mg doses of ondansetron i.v. were given at 4-hour intervals plus 20 mg dexamethasone i.v. infusions from the start of CT, followed by 5 mg dexamethasone i.v. every 12 hours, and the administration of dexamethasone was discontinued after the completion of CT.


RESULTS
The rates of complete protection from acute and delayed vomiting/nausea obtained in these patients were 97.3%/93.2% and 71.2%/60.3%, respectively. The rates of complete protection from both acute and delayed nausea were 70.5% and 58.9%, respectively. By comparison, the total control rate of vomiting was less in female patients than in male patients (p = 0.017), and the total control rate of nausea was lower in the age group less than 50 years (p = 0.045). The time from the start of CT to the onset of nausea appeared to be earlier than that for vomiting (log-rank test, p = 0.045). Adverse events tended to be minor, with constipation and hiccups as the most common.


CONCLUSIONS
These results indicate that i.v. ondansetron plus i.v. dexamethasone is a feasible anti-emetic therapy in an inpatient setting. I.v. ondansetron plus i.v. dexamethasone is highly effective in preventing acute cisplatin-induced nausea and vomiting.
Liaw
C C
CC
Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, R.O.C. el02309@adm.cgmh.com.tw
Wang
C H
CH
Chang
H K
HK
Kao
C Y
CY
Huang
J S
JS
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects*; D003907:Dexamethasone / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000517:prevention & control*; D017294:Ondansetron / Q000008:administration & dosage*; D011446:Prospective Studies; D014839:Vomiting / Q000517:prevention & control*
D000970:Antineoplastic Agents; D017294:Ondansetron; D003907:Dexamethasone; D002945:Cisplatin