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Subcutaneous levomepromazine rescue (SLR) for high grade delayed chemotherapy-induced emesis (DCIE)
1Academic Department of Oncology, Princess Royal Hospital, Saltshouse Road, Hull HU8 9HE, East Yorkshire, U.K.
Background:
Delayed chemotherapy-induced emesis (DCIE) has significant patient and health economic impact. Up to 50% of patients on chemotherapy may develop DCIE. There is no accepted standard of care for DCIE.
Patients And Methods:
A prospective observational study of patients with high grade DCIE needing admission to hospital over a 2-year period. Single cycle delayed anti-emetic failure (DAF) per patient is reported. Twenty-five mg/24 hours subcutaneous levomepromazine rescue (SLR) was used. Control of nausea and vomiting was recorded in 2 time-periods: 0 to 24 hours and 24 to 48 hours.
Results:
Thirty-two patients (12 male, 20 female) required SLR. Median age 58 years (r. 35-76). Grade 0 nausea and vomiting (N and V) was attained within 24 hours in 75% and 81% of patients, respectively, and in 94% of patients for both by 48 hours. Side-effects of sedation and hypotension were mild.
Conclusion:
Levomepromazine has efficacious anti-emetic qualities in the rescue of patients with high grade DCIE needing hospital admission.
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