Journal of Clinical Oncology, Vol 5, 1994-1997, Copyright © 1987 by American Society of Clinical Oncology
A controlled clinical trial of the addition of transdermal scopolamine to a standard metoclopramide and dexamethasone antiemetic regimen
BR Meyer, V O'Mara and MM Reidenberg
Department of Medicine, North Shore University Hospital, Manhasset, NY 11030.
A randomized prospective clinical trial was conducted to evaluate the
potential utility of adding transdermal scopolamine to a standard regimen
of metoclopramide and dexamethasone for the prevention of cisplatin-induced
emesis. Thirty-one patients who were about to receive their first cycle of
chemotherapy, using a combination regimen including cisplatin at a dose
greater than or equal to 60 mg/m2 were randomized to receive an antiemetic
regimen of either metoclopramide and dexamethasone alone, or these two
drugs plus transdermal scopolamine patches. The mean number of episodes of
emesis was .63 +/- 1.31 in the 16 scopolamine-treated patients, and 2.27
+/- 2.66 in the 15 patients who did not receive scopolamine (P less than
.01). The scopolamine appeared to inhibit extrapyramidal reactions to the
metoclopramide, but the number of cases was too small for statistical
significance. We conclude that the addition of transdermal scopolamine to a
standard metoclopramide and dexamethasone antiemetic regimen provides
additive benefit in the control of cisplatin-induced emesis.
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