Treatment with metoclopramide can cause tardive dyskinesia, a serious movement disorder that is often irreversible. The risk of developing cost reglan dyskinesia increases with duration of treatment and total cumulative dose. Metoclopramide therapy should be discontinued in patients who develop signs or symptoms of tardive dyskinesia. There is no known treatment for tardive dyskinesia. In some patients, symptoms may lessen or resolve after metoclopramide treatment is stopped. Treatment with metoclopramide for longer than 12 weeks should be avoided in all but rare cases where therapeutic benefit is thought to outweigh the risk of developing tardive dyskinesia.
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Individual studies have assessed the impact of standard prophylactic therapy with 5-hydroxytryptamine receptor antagonists 5-HT 3 RAs for chemotherapy-induced nausea and vomiting CINV on cost and utilization, but no synthesis of the findings exists. The studies vary in designs, patients, 5-HT 3 RA regimens, and the definition of outcomes. Fewer patients receiving palonosetron versus with ondansetron or other 5-HT 3 RAs required rescue medication or used outpatient or inpatient care. Therefore, the use of palonosetron as a standard treatment may lead to reduced service utilization for CINV. Chemotherapy-induced nausea and vomiting CINV is an adverse effect of cancer treatment. It may occur within a few minutes of or up to 24 hours after the administration of chemotherapy ie, acute CINV, or it may occur more than 24 hours after treatment ie, delayed CINV.
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