Intermediate dose metoclopramide is not more effective than standard dose metoclopramide for patients who present to the emergency department with nausea and vomiting: a pilot study.

OBJECTIVE

To determine whether intermediate dose metoclopramide is more effective than standard dose metoclopramide for patients who present to the ED with nausea and vomiting.

METHODS

This prospective, single-blind, randomized trial was conducted in the ED of two community teaching hospitals in a convenience sample of adult patients who presented to ED with nausea and vomiting. Patients were randomized to receive either 10 mg metoclopramide IV or 0.4 mg/kg IV (up to a maximum dose of 32 mg). The outcomes measured were: change in nausea score (measured on a 11-point verbal rating scale), requirement for other anti-emetic drug administration, and presence of side-effects.

RESULTS

Fifty-eight patients were eligible for analysis (34 in 10 mg group and 24 in 0.4 mg/kg group). Median reduction in nausea score in 10 mg group was four (range 0-10, 95% CI 3-5) compared with five for 0.4 mg/kg group (range -1-10, 95% CI 4-6). This difference was not statistically significant (P = 0.629). Five patients in the 10 mg group required rescue anti-emetic, compared with three in the 0.4 mg/kg group (P = 1.00). There were no side-effects in the 10 mg group and two in the 0.4 mg/kg group.

CONCLUSION

This study suggests that there is no difference in effectiveness between 10 mg and 0.4 mg/kg of metoclopramide in the ED population with nausea and vomiting.