High doses of methylprednisolone with or without alizapride in the prevention of cisplatin-induced emesis. A randomized, double-blind, crossover study.

Fifty-two patients undergoing cisplatin-based chemotherapy were randomized to receive either methylprednisolone (1 g i.v. total dose) or methylprednisolone plus alizapride (800 mg i.v. total dose). Major control of emesis (less than or equal to 2 episodes of vomiting) was obtained in around 30% of patients, without difference between the two arms. The combined antiemetic treatment was significantly superior to the single drug in reducing overall number of vomiting episodes (median: 4 vs. 9), duration of emesis (2 vs. 4.5 h), and number of patients with more than 5 vomiting episodes (47.5 vs. 62.5%). Both antiemetic regimens had negligible toxicity and were easily given to outpatients. Though some superiority has been shown for the combined treatment over the single methylprednisolone, the low rate of major control of emesis does not warrant for further investigations of this regimen in cisplatin-treatment patients.