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Low-dose levomepromazine in refractory emesis in advanced cancer patients: an open-label study

Nicolás Garrigue

Marta Junin

Gustavo G De Simone

Palliative Care Service, Pallium Latinoamerica and Hospital Bonorino Udaondo, Buenos Aires

Seventy patients with advanced cancer and refractory emesis were treated with subcutaneous boluses of levomepromazine (median daily dose: 6.25 mg; range: 3.12-25) in an open-label prospective study. Treatment was associated with a decrease in nausea from a median of 8/10 at baseline (IQR 7-8) to a median of 1 (IQR 0-2) after two days of treatment (P<0.0001); vomiting ceased in 92% of cases. It was possible to remove the nasogastric tube from all 11 patients who had one. The most frequently reported side effect was sedation, with a median of 2/10 (25-75% percentile 1-3), which was not correlated with the dose of levomepromazine. This study suggests that treatment with low-dose levomepromazine is an effective and safe option for advanced cancer patients who fail to respond to first-line antiemetic treatment.

Key Words: advanced cancer • emesis • levomepromazine • palliative care

Palliative Medicine, Vol. 19, No. 1, 71-75 (2005)
DOI: 10.1191/0269216305pm972oa


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