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13-07-2010 | Diabetes | Article

Prophylactic antiemetics effective for exenatide-induced nausea

Abstract

Free abstract

MedWire News: The prophylactic use of oral antiemetic therapy reduces nausea and vomiting in patients taking exenatide, US researchers have shown.

There was no suggestion of a pharmacokinetic interaction between the antiemetic and antidiabetes drugs, leading the team to suggest that oral antiemetics may be useful for mitigating exenatide-induced nausea and vomiting.

The investigators, led by Cinzia Ellero (Amylin Pharmaceuticals Inc, San Diego, California), undertook a retrospective analysis of data from an open-label, parallel-group, single-dose study.

A total of 120 healthy individuals received a 10 µg subcutaneous dose of exenatide. Half of the participants also received two oral antiemetic drugs (metoclopramide and ondansetron hydrochloride) 30 minutes before the exenatide dose.

As expected, the most frequent adverse events associated with exenatide therapy were nausea (39.2%) and vomiting (22.5%), both of mild-to-moderate intensity.

However, the incidence of these two side effects was substantially higher in patients who had not received antiemetics than in those who had, at 61.7% versus 16.7% for nausea and 38.3% versus 6.7% for vomiting.

Individuals premedicated with antiemetics showed a higher incidence of somnolence, at 8.3% versus 1.7% among those who were not premedicated. Drowsiness is a known adverse event associated with both metoclopramide and ondansetron, the authors remark.

Finally, pharmacokinetic analysis revealed that plasma exenatide concentrations were comparable between participants who did and did not receive antiemetics, indicating the absence of a discernable interaction between the two drugs.

Ellero et al conclude: "Prophylactic use of antiemetics may provide an additional short-term strategy for the management of nausea at treatment initiation, during dose escalation and the first weeks of treatment, or in patients who continue to experience nausea over time.

They add: "Additional studies are warranted to investigate the effectiveness of individual anti-emetic medications on nausea and vomiting with exenatide treatment, their ideal timing of administration relative to exenatide dosing, how long to administer these medications during continued treatment with exenatide and the safety of longer-term treatment with antiemetics."

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Joanna Lyford