Lajolo, P.P., & del Giglio, A. (2007). Skipping day 2 antiemetic medications may improve chemotherapy induced delayed nausea and vomiting control: Results of two pilot phase II trials. Supportive Care in Cancer, 15(3), 343-346.
To evaluate whether skipping day 2 antiemetic medications may improve delayed chemotherapy-induced nausea and vomiting (CINV), based on the hypothesis that repeated consecutive doses of antiemetics may lead to increased accumulation of 5-HT3 at the presynaptic level in the gastrointestinal (GI) tract, decreasing the activity of the next dose of a 5-HT3 receptor antagonist (tachyphylaxis)
Patients were given day 1 antiemetics according to American Society of Clinical Oncology (ASCO) guidelines. Patients in Study 1 received 10 mg metochlopramide by mouth every eight hours, 0.05 mg granisetron by mouth four times per day, and 8 mg dexamethasone four times per day on days 2 and 3. In Study 2, patients received the same medications except that no drugs were given on day 2. Patients recorded emetic episodes in diaries and responded to a quality-of-life (QOL) questionnaire at baseline and on day 6.
The studies were conducted in the hematology and oncology department of a School of Medicine in Brazil.
This research consisted of two pilot studies.
The Functional Living Index of Vomiting (FLIE) was used.
Skipping day 2 antiemetic medications does not seem to worsen delayed CINV and may reduce CINV.
Study limitations include the use of a nonrandomized design and the small sample size.