Oral Metoclopramide With or Without Diphenhydramine: Potential for Prevention of Late Nausea and Vomiting Induced by Cisplatin

Late nausea and vomiting lasting 2–7 days occurs in 20%–68% of patients receiving cisplatin. We therefore studied the effects of oral metoclopramide given at doses of 20, 50, or 100 mg four times a day for 25 doses (7 days) beginning after cisplatin to determine the maximum tolerated dose (MTD) for prophylactic oral antiemetic regimens. Patients were stratified into younger (≤130 yr old) and older >30 yr old) groups. Dose escalation was performed without or with concomitant oral diphenhydramine. For the younger group, the MTD for metoclopramide without diphenhydramine was