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Domperidone or metoclopramide in preventing chemotherapeutically induced nausea and vomiting.

Severe and sometimes intractable nausea and vomiting are common side effects of cytotoxic chemotherapy. Most doctors prescribe an antiemetic to accompany cytotoxic chemotherapy, but little data exist on which is the most suitable agent.' Metoclopramide is a widely used antiemetic, but its side effects include drowsiness, extrapyramidal effects such as dystonia or oculogyric crisis, and convulsions; these are particularly common when the recommended dose is exceeded in children.2 Domperidone is a new antiemetic: that hardly penetrates the blood-brain barrier, and even at doses much greater than therapeutic ones no psychotropic or neurological effects have been observed.4 We decided to compare, using a cross-over design, the efficacy of these two antiemetics in preventing nausea and vomiting induced by cytotoxic chemotherapy.