Continuous subcutaneous (SC) infusion of metoclopramide (MCP) using a plastic disposable infusor for the treatment of chemotherapy-induced emesis

This study evaluated the antiemetic effect of a subcutaneous infusion of metoclopramide (MCP) in 24 patients receiving chemotherapy. All patients had received at least one course of chemotherapy and had described their emesis as severe before being admitted to the study. During their first course in this study all patients received chemotherapy plus intravenous antiemetics (MCP 20 to 70 mg plus dexamethasone 10 mg, both 15 minutes before and one hour after treatment) and oral MCP (10 mg) or dimenhydrinate (50 mg) every four hours for the next 24 hours. During their second course, patients received the same type and dose of chemotherapy and intravenous antiemetics plus a subcutaneous infusion of MCP (240 and 120 mg in patients receiving chemotherapy including and excluding cisplatin, respectively). MCP was administered using a portable disposable infusor. The number of vomiting episodes and intensity of nausea were 13 ± 9 and 5.4 ± 1, respectively, during the first course ν 5 ± 7 (P<0.001) and 3.6 ± 1.7 (P<0.001) during the second course, respectively. Toxicity cosisted of drowsiness in eight cases, akathysia in three, and local irritation in one. After the completion of the study, 18 patients (75%) chose to continue the infusion in future courses of chemotherapy. Although blinded studies are needed to confirm our results, this study suggests that continuous infusion of MCP may effectively and safely control nausea in outpatients receiving chemotherapy.