Evaluation of an antiemetic regimen with a high-dose metoclopramide, dexamethasone and diphenhydramine combination in chemotherapy regimens with cisplatin
Abad-Esteve, A.; Rosell, R.; Moreno, I.; Monrás, P.; Fernández, C.; Serichol, M.; Clotet, M.; Ribas Mundó, M.
Medicina Clinica 87(19): 796-798
1986
ISSN/ISBN: 0025-7753 PMID: 3821231 Document Number: 276894
Fifty patients on chemotherapy containing cis-platinum in doses higher than 60 mg/m2 were treated with an antiemetic combination of i.v. methochlopramide 3 mg/kg (2 doses), i.v. dexamethasone 20 mg (1 dose) and oral diphenhydramine 50 mg (1 dose). Forty-four patients were analyzable (32 lung, 4 ovary and 8 head and neck cancers; there were 6 protocol violations). There were 35 males and 9 females, with mean age 63 years (34-76). Mean Karnofsky index was 80% (60-100). Overall 144 cycles were administered, with a mean of 3 cycles. Less than three episodes of nausea or vomiting were considered as a major antiemetic response (MR). Three to five episodes were considered as a minor response (mR), and more than five episodes as a failure (F). A MR was obtained in 41 patients (93%) in the first cycle, with 72% patients showing no episode of vomiting. In the 144 cycles a MR was obtained in 113 (78.5%), a mR in 24 (16.7%) and failure was observed in 7 (4.8%). Failures were already in the first cycle. In 10 patients late vomiting occurred. Toxicity was mild: 13 patients had diarrhoea (29%), 3 had acathisia and 25 had somnolence. No patient refused to continue with the treatment. These results show a remarkable efficacy of the combination used for the control of vomiting induced by chemotherapy containing platinum.