Effect of Prophylactic Anti-emetics on Opioid-induced Nausea and Vomiting: A Retrospective Observational Cohort Study

Overview

Journal In Vivo

Specialty Oncology

Date 2021 Apr 29

PMID 33910857

Citations 1

Authors

Tomoki Tamura

Keita Kawakado

G O Makimoto

Masamoto Nakanishi

Shoichi Kuyama

Affiliations

Soon will be listed here.

Abstract

Background: The guidelines on pharmacotherapy for cancer-related pain advocate active measures against the adverse effects of opioids to increase adherence to medication. However, preventative therapy for the management of nausea and vomiting has not been specified. This study aimed to verify the effects of prophylactic anti-emetics in preventing opioid-induced nausea and vomiting.

Patients And Methods: We conducted a retrospective analysis of cases at our hospital in which oral opioids or patches were initiated for the management of pain due to malignant tumours from January 2017 to September 2019.

Results: Strong opioids were initiated for 349 patients; of these, data for 298 patients were analysed. A total of 193 patients were on anti-emetic prophylaxis. We found that the group that did not receive anti-emetic prophylaxis was significantly more likely to be prescribed an additional anti-emetic.

Conclusion: Prophylactic administration of anti-emetics at the time of initiating opioid analgesics may reduce gastrointestinal toxicity.

Citing Articles

Factors Contributing to Blood Glucose Elevation Associated With Olanzapine Used as an Antiemetic During Cancer Chemotherapy.

Kanbayashi Y, Ishikawa T, Taguchi T, Takayama K In Vivo. 2025; 39(2):902-908.

PMID: 40010992 PMC: 11884464. DOI: 10.21873/invivo.13894.

Effects of single-use alfentanil versus propofol on cognitive functions after colonoscopy: A randomized controlled trial.

Zhu X, Chen X, Zheng X, Lyu H, Chen J, Yan A Heliyon. 2023; 9(6):e17061.

PMID: 37389042 PMC: 10300329. DOI: 10.1016/j.heliyon.2023.e17061.

References

Kanbayashi Y, Hosokawa T . Predictive factors for nausea or vomiting in patients with cancer who receive oral oxycodone for the first time: is prophylactic medication for prevention of opioid-induced nausea or vomiting necessary?. J Palliat Med. 2014; 17(6):683-7. DOI: 10.1089/jpm.2013.0613. View

Tsukuura H, Miyazaki M, Morita T, Sugishita M, Kato H, Murasaki Y . Efficacy of Prophylactic Treatment for Oxycodone-Induced Nausea and Vomiting Among Patients with Cancer Pain (POINT): A Randomized, Placebo-Controlled, Double-Blind Trial. Oncologist. 2017; 23(3):367-374. PMC: 5905679. DOI: 10.1634/theoncologist.2017-0225. View

Tsukuura H, Ando Y, Gyawali B, Matsumoto M, Sugishita M, Honda K . Prophylactic Use of Antiemetics for Prevention of Opioid-Induced Nausea and Vomiting: A Questionnaire Survey among Japanese Physicians. J Palliat Med. 2015; 18(11):977-80. DOI: 10.1089/jpm.2015.0203. View

Yamaguchi T, Shima Y, Morita T, Hosoya M, Matoba M . Clinical guideline for pharmacological management of cancer pain: the Japanese Society of Palliative Medicine recommendations. Jpn J Clin Oncol. 2013; 43(9):896-909. DOI: 10.1093/jjco/hyt099. View

Ishihara M, Iihara H, Okayasu S, Yasuda K, Matsuura K, Suzui M . Pharmaceutical interventions facilitate premedication and prevent opioid-induced constipation and emesis in cancer patients. Support Care Cancer. 2009; 18(12):1531-8. DOI: 10.1007/s00520-009-0775-3. View

Corli O, Santucci C, Corsi N, Radrezza S, Galli F, Bosetti C . The Burden of Opioid Adverse Events and the Influence on Cancer Patients' Symptomatology. J Pain Symptom Manage. 2019; 57(5):899-908.e6. DOI: 10.1016/j.jpainsymman.2019.02.009. View

Giusti R, Mazzotta M, Filetti M, Daniele G, Tsukuura H, Ficorella C . Prophylactic use of antiemetics for prevention of opioid-induced nausea and vomiting: a survey about Italian physicians' practice. Support Care Cancer. 2019; 27(9):3531-3535. DOI: 10.1007/s00520-019-4663-1. View

Sande T, Laird B, Fallon M . The Management of Opioid-Induced Nausea and Vomiting in Patients with Cancer: A Systematic Review. J Palliat Med. 2018; 22(1):90-97. DOI: 10.1089/jpm.2018.0260. View

Walsh D, Davis M, Ripamonti C, Bruera E, Davies A, Molassiotis A . 2016 Updated MASCC/ESMO consensus recommendations: Management of nausea and vomiting in advanced cancer. Support Care Cancer. 2016; 25(1):333-340. DOI: 10.1007/s00520-016-3371-3. View

10.

Laugsand E, Kaasa S, Klepstad P . Management of opioid-induced nausea and vomiting in cancer patients: systematic review and evidence-based recommendations. Palliat Med. 2011; 25(5):442-53. DOI: 10.1177/0269216311404273. View

11.

Ishihara M, Ikesue H, Matsunaga H, Suemaru K, Kitaichi K, Suetsugu K . A multi-institutional study analyzing effect of prophylactic medication for prevention of opioid-induced gastrointestinal dysfunction. Clin J Pain. 2011; 28(5):373-81. DOI: 10.1097/AJP.0b013e318237d626. View

12.

Culver M, Richards E, Jarrell D, Edwards C . Use of Prophylactic Ondansetron with Intravenous Opioids in Emergency Department Patients: A Prospective Observational Pilot Study. J Emerg Med. 2017; 53(5):629-634. DOI: 10.1016/j.jemermed.2017.06.040. View

13.

Okamoto Y, Tsuneto S, Tsugane M, Takagi T, Uejima E . A retrospective chart review of opioid-induced nausea and somnolence on commencement for cancer pain treatment. J Opioid Manag. 2011; 6(6):431-4. DOI: 10.5055/jom.2010.0041. View

14.

Cepeda M, Farrar J, Baumgarten M, Boston R, Carr D, Strom B . Side effects of opioids during short-term administration: effect of age, gender, and race. Clin Pharmacol Ther. 2003; 74(2):102-12. DOI: 10.1016/S0009-9236(03)00152-8. View

15.

Aparasu R, McCoy R, Weber C, Mair D, Parasuraman T . Opioid-induced emesis among hospitalized nonsurgical patients: effect on pain and quality of life. J Pain Symptom Manage. 1999; 18(4):280-8. DOI: 10.1016/s0885-3924(99)00085-8. View