A Pharmacokinetic Study of High-Dose Metoclopramide Suppositories

Hardy, F.; Warrington, P. S.; Macpherson, Janet S.; Hudson, S. A.; Jefferson, Gordon C; Smyth, John F.

doi:10.1111/j.1365-2710.1990.tb00351.x

Cited by 5 publications

(2 citation statements)

References 3 publications

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“…High-dose metoclopramide (150 mg) in suppository form has been used to treat cytotoxic drug-induced nausea and produces both effective plasma concentrations and significant relief [61,178]. Rectally administered metoclopramide at a dose of 25 mg relieves diabetesassociated gastroparesis and achieves therapeutic serum levels [168].…”

Section: Metoclopramidementioning

confidence: 99%

Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions

Davis¹,

Walsh²,

LeGrand

et al. 2002

Support Care Cancer

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Rectally administered medications are essential in palliative medicine, particularly in the last days of life. They are underutilized. The pharmacology of rectally administered medications relates not only to the medication but also to the suppository base, additives, drug ionization, p K(a), absorptive surface of the rectum, and rectal health. The pharmacokinetics may differ from those of orally administered medications owing to reduced hepatic first-pass clearance. In this review the pharmacology of rectally administered palliative medications is reviewed and the use of individual drugs is outlined.

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Section: Metoclopramidementioning

confidence: 99%

Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions

Davis¹,

Walsh²,

LeGrand

et al. 2002

Support Care Cancer

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“…Studies of metoclopramide suppositories have been published [17], however, ondansetron has been shown to be superior to metoclopramide for controlling emesis [3,5].…”

Section: Discussionmentioning

confidence: 99%

Ondansetron Suppository: A Randomised, Double-Blind, Double-Dummy, Parallel-Group Comparison with Oral Ondansetron for the Prevention of Cyclophosphamide Induced Emesis and Nausea

Davidson

Paska²,

Belle³

et al. 1997

Oncology

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This multinational, multicentre, randomised, parallel-group study compared the safety, tolerability and efficacy of ondansetron 8 mg orally twice a day with ondansetron suppository 16 mg once daily in patients receiving cyclophosphamide-containing chemotherapy. A total of 406 patients were randomised to receive ondansetron 8 mg p.o. (198 patients) or ondansetron suppository (208 patients) medication in a double-blind, double-dummy trial. The primary efficacy analysis revealed that ondansetron provided good anti-emetic control with 81% of patients in the 8 mg p.o. b.d. group and 73% of patients in the 16 mg ondansetron suppository o.d. group experiencing complete or major control of emesis (≤ 2 emetic episodes) on the worst day of days 1-3. The 90% confidence interval for the difference between the two treatments for complete or major control (1.4, 15.0%) showed that the treatments could be regarded as equivalent. A difference in favour of oral ondansetron treatment was noted for the complete control (0 emetic episodes) rates over days 1-3, but no differences were found on day 1. There were no significant differences in the distribution of nausea grades between the treatment groups on the worst day of days 1-3 or on day 1. The incidence of adverse events was similar for the two treatment groups, the most frequently reported events were headache and constipation. There were no significant laboratory findings in either treatment group. In conclusion this study showed that the ondansetron treatments could be regarded as equivalent for the primary efficacy endpoint and that ondansetron suppository was well tolerated and effective in the prevention of cyclo-phosphamide-induced emesis.

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Current Updates in Rectal Infusion of Fluids and Medications

Macy

Paxton

Lam

2023

Curr Emerg Hosp Med Rep

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Purpose of Review Rectal infusion is a feasible alternative for the immediate administration of medication and fluids when intravenous access is delayed, contraindicated, or unnecessary. Advances in medical device technology have made rectal infusion more practical and easier for medical care providers, and more comfortable for patients. This paper briefly reviews the history of therapeutic rectal infusion, including recent improvements in technology and the existing evidence for the use of this technique. Recent Findings While ultrasound-guided peripheral intravenous (PIV) access techniques and other alternatives to landmark-based PIV catheter insertion have recently improved the ability of providers to overcome challenges related to difficult vascular access (DVA), these challenges are increasingly affecting patient outcomes, emergency department throughput, and the cost of medical care. In recent years, waves of parenteral drug, fluid, and supply shortages have affected hospitals. Concurrently, advances in rectal infusion technology have made rectal infusion easier, more comfortable, and more cost-effective than many parenteral options. Summary The infusion of resuscitative fluids and medications via the rectal route has previously fallen out of favor due to concurrent improvements in IV access devices. However, this technique demonstrates the potential for a reemergence considering the current challenges facing healthcare providers and systems. Improvements in rectal infusion devices, coupled with an aging population, increased incidence of DVA, shortages in parenteral drugs, fluids, supplies and skilled staff, and the need for care improvements in the post-acute setting have contributed to a greater need for easy, safe and effective alternatives to IV infusion.

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A Pharmacokinetic Study of High-Dose Metoclopramide Suppositories

Cited by 5 publications

References 3 publications

Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions

Symptom control in cancer patients: the clinical pharmacology and therapeutic role of suppositories and rectal suspensions

Ondansetron Suppository: A Randomised, Double-Blind, Double-Dummy, Parallel-Group Comparison with Oral Ondansetron for the Prevention of Cyclophosphamide Induced Emesis and Nausea

Current Updates in Rectal Infusion of Fluids and Medications

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