Antiemetics are a diverse group of drugs used to treat or prevent nausea and vomiting, including that associated with cancer therapy, anaesthesia, and motion sickness (see below).
The choice of drug depends partly on the cause of nausea and vomiting. For example, hyoscine or an antihistamine are used in motion sickness whereas dopamine antagonists (such as metoclopramide and domperidone) and serotonin 5-HT3-receptor antagonists (5-HT3 antagonists), such as ondansetron, are ineffective. Conversely, nausea and vomiting associated with cancer chemotherapy is often hard to control and special regimens have been devised including the use of the 5-HT3 antagonists, dexamemasone, and, more recently, the neurokinin-1 receptor antagonist aprepitant.
Described in this site are:
- Alizapride
- Aprepitant
- Azasetron
- Bromopride
- Cerium Oxalate
- Clebopride
- Difenidol
- Dolasetron
- Domperidone
- Dronabinol
- Fosaprepitant
- Ginger
- Granisetron
- Indisetron
- Itopride
- Mecloxamine Citrate
- Metoclopramide
- Metopimazine
- Nabilone
- Ondansetron
- Palonosetron
- Ramosetron
- Tropisetron
Azasetron Hydrochloride
Drug Nomenclature
Profile
Azasetron is a 5-HT3 antagonist with general properties similar to those of ondansetron. It is used as an antiemetic in the management of nausea and vomiting induced by cytotoxic therapy. Azasetron hydrochloride is given in a usual dose of 10 mg once daily by mouth or intravenously.
Proprietary Preparations
Argentina: Serotone
Japan: Serotone.
Bromopride
Drug Nomenclature
Profile
Bromopride is a substituted benzamide similar to metoclopramide, used in a variety of gastrointestinal disorders including nausea and vomiting and motility disorders. It is given in a usual oral dose of 20 to 60 mg daily in divided doses, or 20 mg daily by intramuscular or intravenous injection. The hydrochloride is also used.
Preparations
Proprietary Preparations
Brazil: Bilenzima Bromoprid Digerex Digesan Digesprid Digestil Digesting Digeston Pangest Plamet Prided I
Italy: Procirex Valopride
Multi-ingredient
Brazil: Digecap-Zimatico Enziprid Lansoprid Primeral
Portugal: Modulanzime.
Cerium Oxalate
Drug Nomenclature
Note
Cerium oxalate has been defined as consisting of about 50% of cerous oxalate ((C2O4)3Ce2,10H2O) with the oxalates of numerous other rare earths, especially lanthanum, praseodymium, and neodymium. Oxalates of the form (C2O4)3Ce2,xH2O are also referred to as cerium or cerous oxalate.
Profile
Cerium oxalate has been used as an antiemetic.
Preparations – Multi-ingredient
Spain: Novonausin
Clebopride
Drug Approvals
(British Approved Name, US Adopted Name, rINN)
INNs in other languages (French, Latin, and Spanish):
Synonyms: LAS-9273Clebopride Malate
Drug Approvals
(British Approved Name Modified, rINNM)
INNs in main languages (French, Latin, and Spanish):
Pharmacopoeias. In Europe.
European Pharmacopoeia, 6th ed. (Clebopride Malate). A white or almost white, crystalline powder. Sparingly soluble in water and in methyl alcohol slightly soluble in dehydrated alcohol practically insoluble in dichloromethane. The pH of a 1% solution in water is 3.8 to 4.2. Protect from light.
Profile
Clebopride is a substituted benzamide similar to metoclopramide, that is used for its antiemetic and prokinetic actions in nausea and vomiting and various other gastrointestinal disorders. It is given as the malate but doses are expressed in terms of the base. Clebopride malate 679 micrograms is equivalent to about 500 micrograms of clebopride. Clebopride malate is given in a usual oral dose equivalent to clebopride 0.5 mg three times daily before meals or 0.5 to 1 mg by intramuscular or intravenous injection for acute symptoms. For dosage in children see below.
Administration in children. Adolescents aged 12 to 20 years may be given clebopride malate orally in a dose equivalent to clebopride 250 micrograms three times daily. An oral dose of 15 to 20 micrograms/kg daily in 3 divided doses may be used for children under 12 the following doses have been recommended:
- 1 to 4 years: 50 micrograms 3 times daily
- 4 to 8 years: 100 micrograms 3 times daily
- 8 to 10 years: 150 micrograms 3 times daily
- 10 to 12 years: 200 micrograms 3 times daily
Preparations
Proprietary Preparations
Argentina: Gastridin
Indonesia: Clast
Italy: Motilex
Portugal: Clebofex Clebutec
Spain: Cleboril.
Multi-ingredient
Argentina: Eudon Gastridin-E Somasedan
Spain: Clanzoflat Flatoril.
Difenidol Hydrochloride
Drug Approvals
(British Approved Name Modified, rINNM)
INNs in main languages (French, Latin, and Spanish):
Pharmacopoeias. In China, and Japan.
Profile
Difenidol hydrochloride is an antiemetic that probably acts through the chemoreceptor trigger zone. It is claimed to control vertigo by means of a specific effect on the vestibular apparatus. Difenidol also has a weak peripheral antimuscarinic action.
It has been used in the treatment of some forms of nausea and vomiting such as those associated with surgery, radiotherapy, and cancer chemotherapy. It has also been used for the symptomatic treatment of vertigo, nausea and vomiting due to Meniere’s disease, and other labyrinthine disturbances.
It has been given in oral doses equivalent to 25 to 50 mg of difenidol every 4 hours as required. Difenidol hydrochloride has also been given parenterally.
Proprietary Preparations
Brazil: Vontrol
Chile: Vontrol
Hong Kong: Cephadol
Japan: Cephadol
Malaysia: Cephadol
Mexico: Biomitin Diphafen Hemetiken Lansenol Nautrol Normavom Serratol Sons Vontrol Voxamine
Philippines: Cephadol
Singapore: Cephadol
Thailand: Cephadol.
Jennifer is a clinical pharmacologist. She helps doctors of all medical specialties choose medications. Jennifer consults about drug dosage, interactions, and side effects.