Suitability of long-acting metoclopramide for prophylaxis of chemotherapy-induced delayed nausea and vomiting.

Delayed nausea and emesis are common after cancer chemotherapy, especially cisplatin-containing regimens. Often no, or inadequate, prophylactic antiemetic cover is prescribed in these usually ambulant patients. Metoclopramide is a very effective drug in preventing the acute emetic and nauseating effects of cisplatin. The long-acting metoclopramide formulations (in the present study: Gastrosil retard) may be effective in preventing the delayed toxicity. 12-hourly dosing of 60 mg long-acting metoclopramide in a typical oncology ward situation led to stable metoclopramide levels of approximately 100ng/ml in the observed 74 h in 18 patients, with the well-known wide plasma concentration variability. The clinical efficacy of long-acting metoclopramide in this indication remains to be evaluated.