The addition of omeprazole to ondansetron for treating chemotherapy-induced nausea and vomiting in pediatric cancer patients
Abstract: Chemotherapy-induced
nausea and vomiting are some of the most disturbing side effects in pediatric
cancer patients. The standard recommendation is the use of 5-hydroxytryptamine
3 receptor antagonist, such as ondansetron, to treat these symptoms. Despite
this treatment, more than 50% of patients still experience nausea and vomiting.
Objective To evaluate the effect of the addition of omeprazole to
ondansetron in the treatment of chemotherapy-induced nausea and vomiting.
Methods A double-blind, randomized, controlled trial was conducted at
Haji Adam Malik Hospital, Medan, North Sumatera, from March to May 2016.
Subjects were children aged 1 to 18 years, diagnosed with cancer, and who
received intravenous chemotherapy. Patients were randomized to receive either a
single dose of ondansetron (0.5 mg/kg) plus placebo or ondansetron (0.5 mg/kg)
plus omeprazole (0.5 mg/kg). The severity of nausea and vomiting were measured
using the Rhodes index of nausea, vomiting, and retching during the 24 hours
after initiation of emetogenic chemotherapy. The primary outcome of efficacy
was the proportion of patients who achieved complete response (lack of nausea/vomiting).
Statistical analysis was performed by Chi-square and Fischer’s exact tests.
Results Seventy eligible pediatric patients were randomized into two
groups: 32 subjects in the ondansetron + placebo group and 38 others in the
ondansetron + omeprazole group. The therapy failed in 50% (16/32) of the
ondansetron + placebo group and 18.4% (7/38) of the ondansetron + omeprazole
group. There was a significant difference in the clinical response between
groups (P=0.01).
Conclusion The addition of omeprazole to ondansetron for the treatment of
chemotherapy-induced nausea and vomiting is more effective than administration
of ondansetron alone.
Keywords: omeprazole;
ondansetron; chemotherapy; vomiting; pediatric cancer
Author: Perjuangan Dapot
Hamonangan Simbolon, Selvi Nafianti, Pertin Sianturi, Bidasari Lubis, Aznan
Lelo
Journal Code: jpkedokterangg180015
