Metoclopramide: An Antiemetic in Chemotherapy Induced Nausea and Vomiting

Chemotherapy induced nausea and vomiting (CINV) are two of the most feared adverse events experienced by cancer patients undergoing chemotherapy. Metoclopramide was derived from procainamide in the 1950s and one of the first drugs investigated in the prophylaxis of nausea and vomiting induced by chemotherapy. The breakthrough came in 1981 with the recognition that high-dose metoclopramide was effective and tolerable in the prevention of cisplatin-induced nausea and vomiting. A combination of highdose metoclopramide and a corticosteroid was the standard antiemetic recommendation until the serotonin (5-HT)3-receptor antagonists, ondansetron, granisetron, tropisetron and dolasetron became available in the beginning of the 1990s. The development of these highly selective (5-HT)3-receptor antagonists with a superior effect and a preferable tolerability profile has limited the use of metoclopramide to be prescribed as a rescue antiemetic, when guideline recommended antiemetic therapy fails.