Metoclopramide: Dose-related toxicity and preliminary antiemetic studies in children receiving cancer chemotherapy

J. C. Allen, Richard J. Gralla, L. Reilly, M. Kellick, C. Young

Research output: Contribution to journalArticle

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Abstract

Prior studies in adults have shown that metoclopramide (MCP), when given in high intravenous (IV) doses (2 mg/kg), is a highly effective antiemetic for chemotherapy-induced vomiting. It is well-tolerated in older adults, but younger adults have an increased disposition to acute extrapyramidal reactions (ERPs). Before studying the efficacy of MCP as an antiemetic in children, we first had to establish the safe dose range. We performed a dose-increase MCP toxicity study in children receiving highly emetic chemotherapy such as cisplatin (120 mg/m2) or cyclophosphamide (>900 mg/m2), beginning with a dose of 0.2 mg/kg and increasing the dose in nine steps to 3 mg/kg. MCP was given every two hours for four doses beginning one-half hour before chemotherapy. To reduce the incidence of ERPs, we added concomitant diphenhydramine. In MCP doses <2 mg, toxicity was minimal. In doses ≥2 mg, 4/27 (15%) had ERPs and 9/27 (33%) had akathisia. Children who received two consecutive days of MCP had a higher frequency of EPRs. Metoclopramide (2 mg/kg) had promising antiemetic efficacy in a preliminary nonrandomized trial. Chemotherapy-experienced children vomited fewer than five times in 9/21 (43%) trials, and new patients vomited fewer than five times in 7/10 (70%) trials. MCP will become more useful as an antiemetic in children if better measures to prevent EPRs can be developed. Chemotherapy-induced emesis has the same negative implications in children as it does in adults and optimum antiemetic regimens can only be discovered by conducting randomized clinical trials in children.

Original languageEnglish (US)
Pages (from-to)1136-1141
Number of pages6
JournalJournal of Clinical Oncology
Volume3
Issue number8
StatePublished - 1985
Externally publishedYes

Fingerprint

Metoclopramide
Antiemetics
Drug Therapy
Neoplasms
Vomiting
Emetics
Diphenhydramine
Psychomotor Agitation
Cyclophosphamide
Cisplatin
Young Adult
Randomized Controlled Trials
Incidence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Allen, J. C., Gralla, R. J., Reilly, L., Kellick, M., & Young, C. (1985). Metoclopramide: Dose-related toxicity and preliminary antiemetic studies in children receiving cancer chemotherapy. Journal of Clinical Oncology, 3(8), 1136-1141.

Metoclopramide : Dose-related toxicity and preliminary antiemetic studies in children receiving cancer chemotherapy. / Allen, J. C.; Gralla, Richard J.; Reilly, L.; Kellick, M.; Young, C.

In: Journal of Clinical Oncology, Vol. 3, No. 8, 1985, p. 1136-1141.

Research output: Contribution to journalArticle

Allen, JC, Gralla, RJ, Reilly, L, Kellick, M & Young, C 1985, 'Metoclopramide: Dose-related toxicity and preliminary antiemetic studies in children receiving cancer chemotherapy', Journal of Clinical Oncology, vol. 3, no. 8, pp. 1136-1141.
Allen, J. C. ; Gralla, Richard J. ; Reilly, L. ; Kellick, M. ; Young, C. / Metoclopramide : Dose-related toxicity and preliminary antiemetic studies in children receiving cancer chemotherapy. In: Journal of Clinical Oncology. 1985 ; Vol. 3, No. 8. pp. 1136-1141.
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