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Ondansetron plus dexamethasone compared to the 'standard' metoclopramide combination
1Medical Oncology Division, Polyclinic Hospital, Perugia, Italy.
Oncology
|May 1, 1993
Summary
Ondansetron plus dexamethasone significantly outperformed metoclopramide plus diphenhydramine in preventing cisplatin-induced nausea and vomiting. This combination offers superior efficacy and better tolerability for chemotherapy patients requiring antiemetic therapy.
Area of Science:
- Oncology
- Pharmacology
Background:
- Cisplatin chemotherapy frequently causes severe nausea and emesis.
- Effective antiemetic prophylaxis is crucial for patient tolerance and treatment adherence.
Purpose of the Study:
- To compare the efficacy and tolerability of ondansetron plus dexamethasone versus metoclopramide plus dexamethasone and diphenhydramine for preventing cisplatin-induced emesis.
Main Methods:
- A multicentre, double-blind, parallel group study.
- 267 patients receiving cisplatin chemotherapy (> or = 50 mg/m2) were evaluated.
- Comparison of ondansetron/dexamethasone vs. metoclopramide/dexamethasone/diphenhydramine regimens.
Main Results:
- Ondansetron/dexamethasone showed superior control of acute emesis (79% vs. 59%) and nausea (77% vs. 66%).
- Complete protection (no nausea/emesis) was achieved in 69% with ondansetron/dexamethasone versus 50% with metoclopramide combination.
- Fewer patients on ondansetron/dexamethasone experienced vomiting on days 2-3 and subsequent cycles, with less sedation and no extrapyramidal reactions.
Conclusions:
- Ondansetron plus dexamethasone is a more effective antiemetic regimen than metoclopramide plus dexamethasone and diphenhydramine.
- This combination offers improved tolerability, with reduced sedation and extrapyramidal side effects.
- Ondansetron-based prophylaxis is recommended for preventing cisplatin-induced emesis.