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Levomepromazine for nausea and vomiting in palliative care

  1. Emily Darvill1,*,
  2. Saskie Dorman2,
  3. Paul Perkins3

Editorial Group: Cochrane Pain, Palliative and Supportive Care Group

Published Online: 30 APR 2013

Assessed as up-to-date: 27 MAR 2013

DOI: 10.1002/14651858.CD009420.pub2

How to Cite

Darvill E, Dorman S, Perkins P. Levomepromazine for nausea and vomiting in palliative care. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD009420. DOI: 10.1002/14651858.CD009420.pub2.

Author Information

  1. 1

    Cheltenham General Hospital, General Medicine, Cheltenham, UK

  2. 2

    Poole Hospital NHS Foundation Trust, Palliative Medicine, Poole, UK

  3. 3

    Sue Ryder Care Leckhampton Court Hospice, Cheltenham, Gloucestershire, UK

*Emily Darvill, General Medicine, Cheltenham General Hospital, Sandford Road, Cheltenham, GL53 7AN, UK. emilydarvill@cantab.net.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 30 APR 2013

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Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

Nausea and vomiting are common, distressing symptoms for patients receiving palliative care. There are several agents which can be used to treat these symptoms. Levomepromazine is an antipsychotic drug which is commonly used to alleviate nausea and vomiting in palliative care settings.

Objectives

To evaluate the efficacy of and adverse events (both minor and serious) associated with the use of levomepromazine for the treatment of nausea and vomiting in palliative care patients.

Search methods

We searched the electronic databases including CENTRAL, MEDLINE, and EMBASE using relevant search terms and synonyms in March 2013.

Selection criteria

Randomised controlled trials of levomepromazine for the treatment of nausea or vomiting, or both, for adults receiving palliative care. Studies where symptoms were thought to be due to pregnancy or surgery were excluded.

Data collection and analysis

The potential relevance of studies was assessed based on titles and abstracts. Any study reports which appeared to meet the inclusion criteria were obtained for further assessment. All three authors read these papers to determine their suitability for inclusion and discussed discrepancies to achieve a consensus.

Main results

The search strategy identified 421 abstracts from which eight studies were considered but all were excluded from the review.

Authors' conclusions

No randomised controlled trials were identified examining the use of levomepromazine for nausea and vomiting in palliative care. Further studies of levomepromazine and other antiemetic agents are needed to provide better evidence for their use in this setting.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Levomepromazine for the treatment of nausea and vomiting in people with advanced disease

Nausea and vomiting are common and very unpleasant symptoms that are often experienced by people receiving palliative care. There are several different drug therapies which are available to treat these symptoms. Levomepromazine was originally used to treat schizophrenia but is also used to control nausea and vomiting. It can be given orally or as an injection. We were unable to identify any randomised controlled trials to find out if levomepromazine is an effective treatment for nausea and vomiting in patients receiving palliative care. There is a need for randomised studies to find out which drugs are the most effective treatments for such symptoms in these patients.