A randomized double-blind trial to compare the clinical efficacyof granisetron with metoclopramide, both combined with dexamethasone in the prophylaxis of chemotherapy-induced delayed emesis

Abstract

In daily practice, a combination of oral dexamethasone and oral granisetron achieves an extremely high control of acute emesis (86% protection). Our data suggest that routine prescription of setrons for delayed phase control is not advisable as it increases costs without any benefit for the majority of patients. Delayed emesis in the rare patients with acute phase emesis remains an unsolved problem.

Delayed emesis: incidence, pattern, prognostic factors and optimal treatment

“…The objectives of treatment for delayed emesis should be: (1) to provide patients with the best treatment able to obtain complete protection from acute emesis starting from the first cycle of chemotherapy; (2) to use regimens that consist of oral agents, facilitating easy outpatient use; (3) to use regimens that contain agents proven to be efficacious and tolerable in this setting; (4) to use treatments that take account of cost factors whenever possible.…”

“…Instead, two recently published studies enrolled both types of patients [1,23]. In these studies, from day 2 to day 5 all patients received dexamethasone (4 mg or 10 mg orally) and were randomised to receive granisetron (1 mg or 2 mg orally) or metoclopramide (10 mg or 20 mg three times a day).…”

Palonosetron (Aloxi®) and dexamethasone for the prevention of acute and delayed nausea and vomiting in patients receiving multiple-day chemotherapy

“…However, the control of delayed CINV [1,14,19,27,29] is still an open problem, especially in patients undergoing multiple-day [5,10,11,24,31] or high-dose (HD) CT [3,4,7,12,22,28,32]. Patients treated with multiple-day CT regimens are at risk for CINV throughout the entire treatment period.…”

Successful treatment of Diamond‐Blackfan anemia with metoclopramide

“…Metoclopramide is a dopamine receptor antagonist and serotonin receptor agonist widely used as an antiemetic and gastric prokinetic drug [15]. Moreover, metoclopramide induces prolactin release from the pituitary [13,14].…”