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Effect of domperidone, ondansetron, olanzapine-containing antiemetic regimen on QT(C) interval in patients with malignancy: a prospective, observational, single-group, assessor-blinded study

Domperidone, ondansetron and olanzapine can prolong the QT interval. The clinical use of combinations of these drugs is not uncommon. Our study aimed to determine the presence of any QTc prolonging effect of the combination when used as antiemetic in patients receiving cancer chemotherapy. We carrie...

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Autores principales: Kamath, Ashwin, Rai, K. Maneesh, Shreyas, R., Saxena, PU Prakash, Banerjee, Sourjya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801395/
https://www.ncbi.nlm.nih.gov/pubmed/33431995
http://dx.doi.org/10.1038/s41598-020-79380-1
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author Kamath, Ashwin
Rai, K. Maneesh
Shreyas, R.
Saxena, PU Prakash
Banerjee, Sourjya
author_facet Kamath, Ashwin
Rai, K. Maneesh
Shreyas, R.
Saxena, PU Prakash
Banerjee, Sourjya
author_sort Kamath, Ashwin
collection PubMed
description Domperidone, ondansetron and olanzapine can prolong the QT interval. The clinical use of combinations of these drugs is not uncommon. Our study aimed to determine the presence of any QTc prolonging effect of the combination when used as antiemetic in patients receiving cancer chemotherapy. We carried out a prospective, observational study of patients with malignancy who were to receive domperidone, ondansetron and olanzapine-containing antiemetic regimen. Electrocardiograms were recorded before and during the administration of antiemetics, for three consecutive days. A blinded assessor determined the QTc interval using Bazett and Fridericia formulae. Thirty-six patients completed the study; 23 (63.9%) were females. There was a statistically significant change in QTc with time (Fridericia, χ(2)(4) = 15.629, p = 0.004; Bazett, χ(2)(4) = 15.910, p = 0.003); QTc on Day 1 was more than that during baseline (p < 0.001); these differences were significant in females (Fridericia, χ(2)(4) = 13.753, p = 0.008; Bazett, χ(2) (4) = 13.278, p = 0.010) but not in males (Fridericia, χ(2) (4) = 4.419, p = 0.352; Bazett, χ(2)(4) = 4.280, p = 0.369). Two female patients had an absolute QTc prolongation (Bazett correction) of > 500 ms. However, no clinically significant adverse events occurred. The findings show that QTc prolongation is a concern with olanzapine alone and in combination with domperidone and ondansetron, and needs to be investigated further.
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spelling pubmed-78013952021-01-12 Effect of domperidone, ondansetron, olanzapine-containing antiemetic regimen on QT(C) interval in patients with malignancy: a prospective, observational, single-group, assessor-blinded study Kamath, Ashwin Rai, K. Maneesh Shreyas, R. Saxena, PU Prakash Banerjee, Sourjya Sci Rep Article Domperidone, ondansetron and olanzapine can prolong the QT interval. The clinical use of combinations of these drugs is not uncommon. Our study aimed to determine the presence of any QTc prolonging effect of the combination when used as antiemetic in patients receiving cancer chemotherapy. We carried out a prospective, observational study of patients with malignancy who were to receive domperidone, ondansetron and olanzapine-containing antiemetic regimen. Electrocardiograms were recorded before and during the administration of antiemetics, for three consecutive days. A blinded assessor determined the QTc interval using Bazett and Fridericia formulae. Thirty-six patients completed the study; 23 (63.9%) were females. There was a statistically significant change in QTc with time (Fridericia, χ(2)(4) = 15.629, p = 0.004; Bazett, χ(2)(4) = 15.910, p = 0.003); QTc on Day 1 was more than that during baseline (p < 0.001); these differences were significant in females (Fridericia, χ(2)(4) = 13.753, p = 0.008; Bazett, χ(2) (4) = 13.278, p = 0.010) but not in males (Fridericia, χ(2) (4) = 4.419, p = 0.352; Bazett, χ(2)(4) = 4.280, p = 0.369). Two female patients had an absolute QTc prolongation (Bazett correction) of > 500 ms. However, no clinically significant adverse events occurred. The findings show that QTc prolongation is a concern with olanzapine alone and in combination with domperidone and ondansetron, and needs to be investigated further. Nature Publishing Group UK 2021-01-11 /pmc/articles/PMC7801395/ /pubmed/33431995 http://dx.doi.org/10.1038/s41598-020-79380-1 Text en © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Kamath, Ashwin
Rai, K. Maneesh
Shreyas, R.
Saxena, PU Prakash
Banerjee, Sourjya
Effect of domperidone, ondansetron, olanzapine-containing antiemetic regimen on QT(C) interval in patients with malignancy: a prospective, observational, single-group, assessor-blinded study
title Effect of domperidone, ondansetron, olanzapine-containing antiemetic regimen on QT(C) interval in patients with malignancy: a prospective, observational, single-group, assessor-blinded study
title_full Effect of domperidone, ondansetron, olanzapine-containing antiemetic regimen on QT(C) interval in patients with malignancy: a prospective, observational, single-group, assessor-blinded study
title_fullStr Effect of domperidone, ondansetron, olanzapine-containing antiemetic regimen on QT(C) interval in patients with malignancy: a prospective, observational, single-group, assessor-blinded study
title_full_unstemmed Effect of domperidone, ondansetron, olanzapine-containing antiemetic regimen on QT(C) interval in patients with malignancy: a prospective, observational, single-group, assessor-blinded study
title_short Effect of domperidone, ondansetron, olanzapine-containing antiemetic regimen on QT(C) interval in patients with malignancy: a prospective, observational, single-group, assessor-blinded study
title_sort effect of domperidone, ondansetron, olanzapine-containing antiemetic regimen on qt(c) interval in patients with malignancy: a prospective, observational, single-group, assessor-blinded study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7801395/
https://www.ncbi.nlm.nih.gov/pubmed/33431995
http://dx.doi.org/10.1038/s41598-020-79380-1
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