Effects of ondansetron alone and in combination with domperidone in the prevention of chemotherapy-induced nausea and vomiting in breast cancer patients

Abstract

The efficacy and safety of ondansetron, administered alone and in combination with domperidone to prevent chemotherapy-induced nausea and vomiting of breast cancer patients receiving chemotherapy FAC regimen (5-fluorouracil, adriamycin and cyclophosphamide) were evaluated. A consecutive open-label interventional study was conducted on a total number of 86 female breast cancer patients who were receiving chemotherapy. Forty two patients received ondansetron (8 mg) intravenously 30 min before chemotherapy which is followed by ondansetron (8 mg) administered orally every 8 hourly for 2 days from the day of start of chemotherapy. Another 44 patients received ondansetron (8 mg) intravenously 30 min before chemotherapy followed by ondansetron (8 mg) plus domperidone (20 mg) administered orally 8 hourly for 48 hours from the day of start of chemotherapy. The number of emetic episodes, severity of nausea, assessment of appetite and adverse events were recorded at 8 hour intervals for two days study period using specific scoring criteria. Ondansetron in combination with domperidone significantly decreased the chemotherapy-induced nausea and vomiting in comparison with ondansetron administered alone (P<0.001). Appetite status was good with combination therapy (P<0.001). Improvement in appetite indicates that ondansetron plus domperidone exert protective effect against nausea and maintain normal appetite, while patients who were getting monotherapy experience loss of appetite. The common adverse event, headache was present in both the groups. No extrapyramidal reaction was observed in any group. This study showed that ondansetron plus domperidone exert more pronounced antiemetic effect in patients with breast cancer receiving moderately emetogenic chemotherapy (FAC regimen) with good appetite status and less adverse effect.

Keywords

• Chemotherapy
• Domperidone
• FAC regimen
• Nausea
• Ondansetron
• Vomiting