High-dose metoclopramide + lorazepam versus low-dose metoclopramide + lorazepam + dehydrobenzperidol in the treatment of cisplatin-induced nausea and vomiting

Jørn Herrstedt, J Hannibal, Jesper Hallas, E Andersen, L C Laursen, M Hansen

6 Citations (Scopus)

Abstract

In a randomized double-blind, cross-over trial of 34 patients receiving cisplatin-based chemotherapy (20-100 mg/m2), the antiemetic effect of high-dose metoclopramide (HDM) (10 mg/kg iv. loading dose + 7 hours continuous infusion) + lorazepam (L) (2.5 mg x 4 po) was compared with low-dose metoclopramide (LDM) (70 mg) + L (2.5 mg x 2 po) + dehydrobenzperidol (5 mg x 2 im). Among the 29 patients who completed the cross-over, HDM significantly reduced the number of vomiting episodes (p = 0.002) and the degree of nausea (p = 0.004). Seventeen patients preferred the HDM and 4 the LDM regimen (p = 0.01). Sedation was seen in all but 1 patient, and was graded as severe in 6 patients receiving the HDM and in 2 patients receiving the LDM regimen. No extrapyramidal adverse reactions were seen. We conclude that high-dose metoclopramide + lorazepam is a safe antiemetic regimen and significantly superior to low-dose metoclopramide + lorazepam + dehydrobenzperidol. Owing to the severe sedation which occurs in some patients, the dose of lorazepam should be individually adjusted.
Original languageEnglish
JournalAnnals of oncology : official journal of the European Society for Medical Oncology / ESMO
Volume2
Issue number3
Pages (from-to)223-7
Number of pages5
ISSN0923-7534
Publication statusPublished - Mar 1991

Keywords

  • Adult
  • Aged
  • Cisplatin
  • Double-Blind Method
  • Droperidol
  • Drug Therapy, Combination
  • Female
  • Humans
  • Lorazepam
  • Male
  • Metoclopramide
  • Middle Aged
  • Nausea
  • Vomiting

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