It causes central and peripheral dopamine D 2 antagonism at low doses, and weak 5-HT 3 blockade at the higher doses used for emesis caused by cytotoxic drug therapy
Abstract In a study of the effectiveness of high intravenous doses of metoclopramide as an antiemetic, 41 patients with advanced cancer
1991; 9: 721–728 [Google Scholar] Abstract
Although metoclopramide is highly effective against cisplatin, the most emetogenic chemotherapeutic agent to date, it should not be assumed that metoclopramide will be
3 mg IV 8 mg oral or IV 8 mg oral or IV on days 2-3e Low Emetic Riskf 5-HT3 Receptor Antagonist Granisetron 2 mg oral or 1 mg or 0
7326/0003-4819-113-11-834 To compare the efficacy and side effects of ondansetron with those of high-dose metoclopramide in treating acute and delayed
For the prevention of nausea and vomiting after the first
Purpose: The role of 5-HT3 receptor antagonists in the prevention of chemotherapy-induced delayed emesis is controversial
The initial two doses should be 2 mg/kg if highly emetogenic drugs such as cisplatin or dacarbazine are used alone or in combination
A combination of metoclopramide, dexamethasone, droperidol, lorazepam, and diphenhydramine was used in prophylaxis of high-dose (greater than or equal to 100 mg/m2) or moderate dose (greater than or equal to 50 mg/m2) cisplatin
(See Pediatric Use under Cautions
The results of 3 sequential trials established the superiority of metoclopramide over placebo, prochlorperazine, and tetrahydrocannabinol
)
d
For the prevention of nausea and vomiting after the first day of cisplatin-based chemotherapy, both aprepitant and metoclopramide when used in combination with dexamethasone were found to be similarly effective, according to findings of a randomized, double-blind trial presented at the MASCC-ISOO 2014 International Symposium
Patients were stratified according to age and tumor type, then randomized to receive either oral or intravenous (IV) high-dose metoclopramide
Palonosetron (Aloxi) or fosaprepitant dimeglumine (Emend) antiemetic therapy for either of the following indications: The prevention of acute nausea or vomiting associated with initial and repeat courses of moderately and highly emetogenic cancer chemotherapy, including high-dose cisplatin; or
To determine the contribution of metoclopramide to the efficacy of ondansetron in control of cisplatin-induced emesis, ondansetron was compared with ondansetron plus metoclopramide for antiemetic efficacy in a randomized double-blind trial
Results: In low dose cisplatin regimen, complete suppression of acute emesis occurred in 65 per cent patients receiving ondansetron versus 30 per cent receiving metoclopramide, while in high dose regimen, complete response rate was 20 per cent with ondansetron versus 0 per cent with metoclopramide
The median number of emetic episodes for the first 24 hours were as follows: droperidol 3
Complete protection from nausea, but not from vomiting
These symptoms may be incapacitating and are frequently given as a reason to discontinue therapy