Evaluation of olanzapine for breakthrough emesis in patients with cancer not responding to standard antiemetic regimen.

Emerging Role of Olanzapine for Prevention and Treatment of Chemotherapy‐Induced Nausea and Vomiting

“…Grade 3 or 4 toxicities have not been reported with olanzapine in phase III CINV studies . The most common adverse drug reactions reported include fatigue, drowsiness, somnolence, and dyspepsia . In phase III studies comparing olanzapine with either metoclopramide or aprepitant, no significant differences were noted in pain, fatigue, disturbed sleep, distress, problems remembering, shortness of breath, lack of appetite, feeling drowsy, dry mouth, feeling sad, numbness, general activity, mood, work, relations, enjoyment, or sedation .…”

“…In addition to the trial cited earlier, a few other reports have specifically evaluated olanzapine for use in the treatment of breakthrough or refractory CINV. One report evaluated patients who received HEC and ondansetron, a corticosteroid, and metoclopramide; they were given olanzapine 5 mg orally twice/day for two doses to treat breakthrough CINV . Forty‐six patients were evaluable, with CR rates of 61% for emesis and 50% for nausea.…”

“…One report evaluated patients who received HEC and ondansetron, a corticosteroid, and metoclopramide; they were given olanzapine 5 mg orally twice/day for two doses to treat breakthrough CINV. 44 Forty-six patients were evaluable, with CR rates of 61% for emesis and 50% for nausea. With respect to treating refractory CINV, a single retrospective study of 31 adults experienced CINV after receiving prophylaxis appropriately based on emetogenicity level (10 patients received HEC, 23 patients received low to moderate emetogenic regimens) and appropriate first-line treatment for breakthrough CINV with dopamine antagonists and benzodiazepines.…”

“…38,39,41,42 The most common adverse drug reactions reported include fatigue, drowsiness, somnolence, and dyspepsia. 36,44 In phase III studies comparing olanzapine with either metoclopramide or aprepitant, no significant differences were noted in pain, fatigue, disturbed sleep, distress, problems remembering, shortness of breath, lack of appetite, feeling drowsy, dry mouth, feeling sad, numbness, general activity, mood, work, relations, enjoyment, or sedation. 39,42 Metabolic changes such as weight gain, hyperglycemia, and dyslipidemia have been associated with long-term use of olanzapine but were not notable in CINV studies.…”

A review of olanzapine as an antiemetic in chemotherapy-induced nausea and vomiting and in palliative care patients

“…A phase II study, published only as an abstract at ASCO 2011, carried out in patients submitted to highly and moderately emetogenic drugs who presented breakthrough emesis (at least one vomiting episode) despite standard antiemetic administration of ondansetron, a corticosteroid and metoclopramide received olanzapine 5 mg orally every 12 h for 2 doses [25]. In the following 24 h complete response with no vomiting was reported by 60.8% of patients and partial response with one vomiting episode by 17.4% of patients.…”