Summary
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<0.01) and freedom from vomiting (P<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<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.
Similar content being viewed by others
References
Allan SG, Cornbleet MN, Warrington PS, Golland IM, Leonard RCF, Smyth JF (1984) Dexamethasone and high dose metoclopramide: efficacy in controlling ciplatin-induced nausea and vomiting. Br Med J 289: 878
Baharav E, Harpaz D, Mittelman M, Lewinski UH (1986) Dexamethasone-induced perineal irritation. N Engl J Med 314: 515
Barltrop D, Diba YT (1969) Paraesthesiae after IV efcortesol. Lancet I: 529
Bishop JF, Olver IN, Wolf MM, Matthews JP, Long M, Bingham J, Hillcoat BL, Cooper IM (1984) Lorazepam: a randomised, double blind, crossover study of a new antiemetic in patients receiving cytotoxic chemotherapy and prochlorperazine. J Clin Oncol 2: 691
Bluming AF, Zeegan P (1986) Cataracts induced by intermittent decadron used as an antiemetic. J Clin Oncol 4: 221
Dixon WJ (ed) (1981) Biomedical computer programs. University of California Press, Los Angeles p 555
Gralla RJ (1983) Metoclopramide: a review of antiemetic trials. Drugs 25 [Suppl 1]: 63
Gralla RJ, Itri LM, Pisko SE, Squillante AE, Kelsen DP, Braun DW, Bordin LA, Braun TJ, Young CW (1981) Antiemetic efficacy of high-dose metoclopramide: randomised trials with placebo and prochlorperazine in patients with chemotherapy induced nausea and vomiting. N Engl J Med 305: 905
Kris MG, Gralla RJ, Tyson LB, Clark RA, Kelson DP, Reilly LK, Groshen S, Bosl GJ, Kalman LA (1985) Improved control of cisplatin-induced emesis with high dose metoclopramide and with combinations of metoclopramide, dexamethasone and diphenydramine. Cancer 55: 527
Laszlo J (1981) Emesis as a critical problem in chemotherapy. N Engl J Med 305: 938
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Palmer, M.C., Colls, B.M. Amelioration of cytotoxic-induced emesis with high-dose metoclopramide, dexamethasone and lorazepam. Cancer Chemother. Pharmacol. 19, 331–334 (1987). https://doi.org/10.1007/BF00261483
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00261483