Journal of Clinical Oncology, Vol 2, 782-787, Copyright © 1984 by American Society of Clinical Oncology
Comparison of the antiemetic effect of high-dose intravenous metoclopramide and high-dose intravenous haloperidol in a randomized double-blind crossover study
SM Grunberg, KV Gala, M Lampenfeld, D Jamin, K Johnson, P Cariffe, D Strych and M Krailo
Metoclopramide is an effective antiemetic for cisplatin-induced vomiting
when given in parenteral high-dose regimens but not oral low- dose
regimens. Metoclopramide was compared to haloperidol, also given in a
high-dose parenteral regimen. Patients received two cycles of cisplatin at
a dose greater than or equal to 70 mg/m2. Metoclopramide (2 mg/kg
intravenous) was given every two hours for five doses beginning one half
hour before cisplatin. Haloperidol (3 mg intravenous) was given on the same
schedule. A randomized double-blind crossover design was used to control
subjective bias and to compare the same patient's experiences. Twenty-eight
patients completed both study arms. Excellent control of vomiting was
achieved with both drugs. Metoclopramide resulted in 1.92 vomiting episodes
(range, 0-5) with 36% having no vomiting. Haloperidol resulted in 3.04
vomiting episodes (range, 0-8) with 20% having no vomiting. Significantly
fewer vomiting episodes were noted with metoclopramide rho = .006, paired
sign test). However, responses to the two drugs were well correlated
(Spearman's rho = .39, P = .03). Metoclopramide and haloperidol are both
excellent antiemetics when given in sufficient dosage by an effective
route. Metoclopramide does show a mild advantage. However, the positive
correlation in response to these agents suggests a common mechanism of
action. The ability to identify related antiemetics will be useful in the
design of rational combination antiemetic therapy.
