Controversy on ondansetron: Ondansetron is not associated with vascular adverse events, thrombocytopenia or renal failure

Castle, W M; Cunningham, K.; Kanarek, B. B.

doi:10.1093/oxfordjournals.annonc.a058340

Cited by 8 publications

(2 citation statements)

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“…Thrombocytopenia, renal insufficiency and thrombotic episodes in 8 patients receiving ondansetron and cisplatin chemotherapy have also been described (Coates et al 1992). On the other hand, an analysis of all patients entering comparative clinical trials of ondansetron have shown that vascular occlusive events were uncommon and occurred with equal frequency in patients receiving ondansetron and those receiving comparator drugs (Castle et al 1992;Gralla 1992).…”

Section: Ondansetronmentioning

confidence: 99%

Reducing Chemotherapy-Induced Nausea and Vomiting Current Perspectives and Future Possibilities

Favero

Roila²,

Tonato³

1993

Drug Safety

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Nausea and vomiting are among the most distressing adverse effects of cancer chemotherapy. In the last 10 years considerable advances in the prevention of chemotherapy-induced emesis have been made. From an analysis of the results obtained in patients receiving moderately- to severely-emetogenic drugs the following guidelines in choosing the best antiemetic treatment can be given: 1. For the prevention of acute emesis induced by a high single dose of cisplatin (> or = 50 mg/m2) or by low doses (20 to 40 mg/m2) repeated for 4 to 5 days, the combination of ondansetron plus dexamethasone is the most efficacious and least toxic antiemetic therapy. 2. For the prevention of delayed emesis the combination of oral dexamethasone plus metoclopramide seems to offer the best protection, although over 40% of patients still experience delayed nausea and vomiting. 3. For the prevention of acute emesis induced by moderately emetogenic drugs, corticosteroids (dexamethasone or methylprednisolone) are efficacious and safe antiemetic agents. Although equally efficacious, the serotonin (5-HT)3 receptor antagonists, due to their higher acquisition costs, are indicated only in patients refractory to corticosteroids or in those who cannot use them. Unresolved problems in antiemetic research include: (i) identification of the best antiemetic treatment for those areas of cancer chemotherapy where adequate data are lacking, such as high dose regimens for bone marrow transplantation; (ii) optimisation of treatment for the most widely used chemotherapy regimens; and (iii) identification of the best rescue treatment for patients who fail to respond to antiemetic prophylaxis. Although many new 5-HT3 antagonists are currently being studied, the possible improvement in efficacy and tolerability brought about by these agents will probably only be marginal.

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Section: Ondansetronmentioning

confidence: 99%

Reducing Chemotherapy-Induced Nausea and Vomiting Current Perspectives and Future Possibilities

Favero

Roila²,

Tonato³

1993

Drug Safety

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“…Three investigators have, how ever, reported extrapyramidal side effects attributed to ondansetron [23][24][25]. Some investigators also associated the use o f ondansetron with thrombotic episodes, thrombo cytopenia and renal insufficiency [26,27], Others believe that there is not conclusive evidence that ondansetron con tributed to these events [28]. None o f these adverse experi ences have been reported with tropisetron.…”

Section: Treatment Efficacymentioning

confidence: 99%

Antiemetic Efficacy of Tropisetron in Patients Failing Previous Antiemetic Therapy

Falkson

Falkson²

1995

Oncology

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Tropisetron was studied for efficacy and safety in 164 patients who were refractory to other antiemetic agents. 5 mg tropisetron was given intravenously, followed by 5 mg by mouth per day for 4 days. Complete prevention of nausea and vomiting was documented in 42% of patients on day 1 of cycle 1. Delayed nausea and vomiting were prevented in 41% in the first cycle. The antiemetic control did not decrease with subsequent cycles. Side effects ascribed to tropisetron were mild.

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Repeated use of granisetron in patients receiving cytostatic agents

Wet

Falkson

Rapoport

1993

Cancer

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Background. Granisetron was shown to be a safe and effective antiemetic agent when given with initial cytostatic therapy. This study was undertaken to investigate the efficacy and safety of the continued use of granisetron. Methods. Ninety‐one patients were given 438 cycles of granisetron during subsequent courses of cytostatic treatment. In 56 patients, 40 μg/kg IV was given in 159 cycles, and in 42 patients, 3 mg IV was given in 279 cycles. In patients having breakthrough symptoms, as many as two rescue doses were given to re‐establish control. Results. Overall objective control of nausea and vomiting was observed in 88.6% of the 40 μg/kg‐cycles and in 90.32% of the 3‐mg cycles. In the 438 cycles given, complete control was achieved in 105 of 159 (66%) of the 40‐μg/kg cycles and in 217 of 279 (77.78%) of the 3‐mg cycles. Thirty‐three patients received 97 cycles of cisplatin‐based regimens. The objective control rate was 82.47% (80 of 97 cycles) in these patients. The control rate in patients receiving regimens not containing cisplatin was 94.4% (322 of 341 cycles). Rescue doses improved or resolved symptoms in 53 of 61 (86.9%) cycles. No statistically significant difference in nausea and vomiting control was seen between men and women or between the different age groups. The only toxicities encountered were headache in 14 of 438 (3.2%) cycles and mild constipation in 8 of 438 (1.8%) cycles. Conclusion. Granisetron is safe and well tolerated, maintains its antiemetic efficacy after repeated cycles of therapy, and is effective as an interventional treatment for nausea and vomiting.

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Controversy on ondansetron: Ondansetron is not associated with vascular adverse events, thrombocytopenia or renal failure

Cited by 8 publications

References 1 publication

Reducing Chemotherapy-Induced Nausea and Vomiting Current Perspectives and Future Possibilities

Reducing Chemotherapy-Induced Nausea and Vomiting Current Perspectives and Future Possibilities

Antiemetic Efficacy of Tropisetron in Patients Failing Previous Antiemetic Therapy

Repeated use of granisetron in patients receiving cytostatic agents

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