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Using haloperidol as an anti-emetic in palliative care: informing practice through evidence from cancer treatment and post-operative contexts
Blenkinsopp, Alison Bennett, M.I.
Blenkinsopp, Alison
Bennett, M.I.
Publication Date
2013
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© 2013 Taylor & Francis. This is an Author's Original Manuscript of an article published by Taylor & Francis in Journal of Pain & Palliative Care Pharmacotherapy in 2013, available online at http://www.tandfonline.com/10.3109/15360288.2013.782937
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Open Access status
openAccess
Accepted for publication
09/03/2013
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Department
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Abstract
Nausea and vomiting are common symptoms in palliative care. Haloperidol is often used as an antiemetic in this context, although direct evidence supporting this practice is limited. To evaluate the efficacy and clinical use of haloperidol as an antiemetic in nonpalliative care contexts to inform practice, the authors conducted a rapid review of (i) published evidence to supplement existing systematic reviews, and (ii) practical aspects affecting the use of haloperidol including formulations and doses that are commonly available internationally. In nausea and vomiting related to cancer treatment, haloperidol was superior to control in two small studies. In postoperative nausea and vomiting (PONV), two randomized controlledtrials found treatment with haloperidol comparable to ondansetron. In palliative care, an observational study found a complete response rate of 24% with haloperidol (one in four patients) which would be consistent with a number needed to treat (NNT) of 3 to 5 derived from PONV. There remains insufficient direct evidence to definitively support the use of haloperidol for the management of nausea and vomiting in palliative care. However, generalizing evidence from other clinical contexts may have some validity.
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Accepted manuscript
Citation
McLean SL, Blenkinsopp A and Bennett MI (2013) Using haloperidol as an anti-emetic in palliative care: informing practice through evidence from cancer treatment and post-operative contexts. Journal of Pain & Palliative Care Pharmacotherapy. 27(2): 132-135.
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Article