Effects of a Rebamipide Mouthwash on Stomatitis Caused by Cancer Chemotherapy<br/>&mdash;Evaluation of the Efficacy by Patients Themselves&mdash;

Abstract

Anticancer drug-induced stomatitis develops in 30％ to 40％ of cancer cases that undergo chemotherapy. However, medications for this condition are not commercially available in Japan. Upon obtaining approval of the ethics committee, a mouthwash containing rebamipide as the active ingredient (rebamipide mouthwash) was administered to one inpatient and four outpatients, who had developed stomatitis caused by cancer chemotherapy. Starting from 14 d after the administration of the rebamipide mouthwash, the patients scored a stomatitis survey on oral state, pain level, and diet and recorded the number of times they gargled, as well as any stomatitis observations, in a stomatitis diary. The total scores for the points for each of the three types of survey sections were classiˆed into Grades 0 to 4 and evaluated as a stomatitis evaluation score (SES). The SES became``0'' in three out of theˆve patients within 14 d of treatment. No change in SES was found in one patient. In the remaining patients, SES became``0'' once but increased again later. Using image analysis software (ImageJ), the area at which the stomatitis was observed was measured. When comparing SES and change in the area in patients who agreed to participate, gradual reductions in the extent of stomatitis was observed even during the period when SES did not change. Having patientsˆll in an observation chart was eŠective for grasping changes in symptoms in outpatients.

Microparticulated Mefenamic Acid with High Dispersion Stability for Pediatric Dosage Form

“…Therefore, syrups containing MFA are sold with MFA dispersed in a dispersant, but MFA readily precipitates and accumulates at the bottom of the container. Thus, the user must thoroughly shake the MFA when taking the drug to ensure a homogeneous dispersion system, which may reduce patients’ adherence to the medication [ 4 ]. These factors have led to the need to develop MFA-containing syrups with high dispersion stability.…”

Preparation and Evaluation of Rebamipide Colloidal Nanoparticles Obtained by Cogrinding in Ternary Ground Mixtures

“…However, many side effects have been reported, including cell toxicity (such as myelosuppression, cardiac toxicity, renal dysfunction, hepatic dysfunction, and stomatitis) and digestive symptoms (such as nausea and diarrhea) [4][5][6][7]. In particular, 40-70% of patients develop stomatitis, which induces pain in the oral cavity, decreases food intake, causes psychological stress, and reduces the quality of life (QOL) remarkably [8,9]. Furthermore, treatment and/or prevention of stomatitis is an important issue for chemotherapy or radiotherapy if it becomes serious [8,9].…”

“…In particular, 40-70% of patients develop stomatitis, which induces pain in the oral cavity, decreases food intake, causes psychological stress, and reduces the quality of life (QOL) remarkably [8,9]. Furthermore, treatment and/or prevention of stomatitis is an important issue for chemotherapy or radiotherapy if it becomes serious [8,9].…”

“…Currently, indomethacin, which has an analgesic effect, or allopurinol and rebamipide (RB), which have a free radical scavenging effect, are administered to treat stomatitis caused by chemotherapy and radiotherapy [8,[11][12][13][14][15][16][17][18][19]. Allopurinol has a good treatment effect on stomatitis; however, it interacts with fluorouracil, which decreases its anticancer effect, and it has been reported that there are restrictions to its administration [20,21].…”

“…On the other hand, RB can be administered in any case because there is no interaction with anticancer agents [22]. In addition, it has been reported that RB works effectively to treat stomatitis as a free radical scavenger, as an anti-inflammatory drug, and by inducing mucosal repair in phases I-IV [8,11,23].…”