Comparison of the antiemetic efficacy of two high-dose benzamides, metoclopramide and alizapride, against cisplatin-induced emesis.

The antiemetic effect of two benzamides, metoclopramide (MCL; Paspertin) and alizapride (AZP; Vergentan), was compared in two double-blind sequential analytical trials in cisplatin-treated patients (60-90 mg/m2). In the first trial, the drugs were given as loading infusions (0.5 mg/kg of body weight/hour over 2 hours) beginning 2 hours before cisplatin administration; the maintenance infusion (0.25 mg/kg/hour) given over 24 hours was half the dose (total dose, 7 mg/kg of body weight per treatment cycle). In the second trial, the dose of AZP was doubled. After nine and ten treatment pairs, MCL was significantly (2P less than 0.10) more effective than AZP: three of nine and four of ten patients receiving MCL remained totally free from vomiting, compared with only none of nine and one of ten patients receiving AZP. The incidence of extrapyramidal reactions was similar in all treatments. However, the administration of AZP was much more unfavorable because of moderate to severe hypotensive side effects.