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Annals of Oncology 2:223-227, 1991
© 1991 European Society for Medical Oncology

research-article

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

J. Herrstedt1,2, J. Hannibal1, J. Hallas1, E. Andersen1, L. C. Laursen1 and M. Hansen1

1Department of Internal Medicine C, Bispebjerg Hospital, University of Copenhagen Denmark
2Department of Oncology, Herlev Hospital, University of Copenhagen Denmark

Correspondence to: Jorn Herrstedt, M.D. Department of Oncology, Herlev Hospital, University of Copenhagen, DK-2730 Herlev, Denmark

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.

antiemetics, cisplatin, continuous infusion, high-dose metoclopramide, lorazepam, nausea


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