Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting
Background: Haloperidol is widely prescribed as an antiemetic in patients receiving palliative care, but there is limited evidence to support and refine its use. Objective: To explore the immediate and short-term net clinical effects of haloperidol when treating nausea and/or vomiting in palliati...
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| Format: | Article |
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Mary Ann Liebert
2018
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| Online Access: | https://eprints.nottingham.ac.uk/49227/ |
| _version_ | 1848797950116888576 |
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| author | Digges, Madeline Hussein, Akram Wilcock, Andrew Crawford, Gregory B. Boland, Jason W. Agar, Meera R. Sinnarajah, Aynharan Currow, David C. Johnson, Miriam J. |
| author_facet | Digges, Madeline Hussein, Akram Wilcock, Andrew Crawford, Gregory B. Boland, Jason W. Agar, Meera R. Sinnarajah, Aynharan Currow, David C. Johnson, Miriam J. |
| author_sort | Digges, Madeline |
| building | Nottingham Research Data Repository |
| collection | Online Access |
| description | Background: Haloperidol is widely prescribed as an antiemetic in patients receiving palliative care, but there is limited evidence to support and refine its use.
Objective: To explore the immediate and short-term net clinical effects of haloperidol when treating nausea and/or vomiting in palliative care patients.
Design: A prospective, multicenter, consecutive case series.
Setting/Subjects: Twenty-two sites, five countries: consultative, ambulatory, and inpatient services.
Measurements: When haloperidol was started in routine care as an antiemetic, data were collected at three time points: baseline; 48 hours (benefits); day seven (harms). Clinical effects were assessed using the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE).
Results: Data were collected (May 2014–March 2016) from 150 patients: 61% male; 86% with cancer; mean age 72 (standard deviation 11) years and median Australian-modified Karnofsky Performance Scale 50 (range 10–90). At baseline, nausea was moderate (88; 62%) or severe (11; 8%); 145 patients reported vomiting, with a baseline NCI CTCAE vomiting score of 1.0. The median (range) dose of haloperidol was 1.5 mg/24 hours (0.5–5 mg/24 hours) given orally or parenterally. Five patients (3%) died before further data collection. At 48 hours, 114 patients (79%) had complete resolution of their nausea and vomiting, with greater benefit seen in the resolution of nausea than vomiting. At day seven, 37 (26%) patients had a total of 62 mild/moderate harms including constipation 25 (40%); dry mouth 13 (21%); and somnolence 12 (19%).
Conclusions: Haloperidol as an antiemetic provided rapid net clinical benefit with low-grade, short-term harms. |
| first_indexed | 2025-11-14T20:12:01Z |
| format | Article |
| id | nottingham-49227 |
| institution | University of Nottingham Malaysia Campus |
| institution_category | Local University |
| last_indexed | 2025-11-14T20:12:01Z |
| publishDate | 2018 |
| publisher | Mary Ann Liebert |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | nottingham-492272020-05-04T19:24:28Z https://eprints.nottingham.ac.uk/49227/ Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting Digges, Madeline Hussein, Akram Wilcock, Andrew Crawford, Gregory B. Boland, Jason W. Agar, Meera R. Sinnarajah, Aynharan Currow, David C. Johnson, Miriam J. Background: Haloperidol is widely prescribed as an antiemetic in patients receiving palliative care, but there is limited evidence to support and refine its use. Objective: To explore the immediate and short-term net clinical effects of haloperidol when treating nausea and/or vomiting in palliative care patients. Design: A prospective, multicenter, consecutive case series. Setting/Subjects: Twenty-two sites, five countries: consultative, ambulatory, and inpatient services. Measurements: When haloperidol was started in routine care as an antiemetic, data were collected at three time points: baseline; 48 hours (benefits); day seven (harms). Clinical effects were assessed using the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI CTCAE). Results: Data were collected (May 2014–March 2016) from 150 patients: 61% male; 86% with cancer; mean age 72 (standard deviation 11) years and median Australian-modified Karnofsky Performance Scale 50 (range 10–90). At baseline, nausea was moderate (88; 62%) or severe (11; 8%); 145 patients reported vomiting, with a baseline NCI CTCAE vomiting score of 1.0. The median (range) dose of haloperidol was 1.5 mg/24 hours (0.5–5 mg/24 hours) given orally or parenterally. Five patients (3%) died before further data collection. At 48 hours, 114 patients (79%) had complete resolution of their nausea and vomiting, with greater benefit seen in the resolution of nausea than vomiting. At day seven, 37 (26%) patients had a total of 62 mild/moderate harms including constipation 25 (40%); dry mouth 13 (21%); and somnolence 12 (19%). Conclusions: Haloperidol as an antiemetic provided rapid net clinical benefit with low-grade, short-term harms. Mary Ann Liebert 2018-01-01 Article PeerReviewed Digges, Madeline, Hussein, Akram, Wilcock, Andrew, Crawford, Gregory B., Boland, Jason W., Agar, Meera R., Sinnarajah, Aynharan, Currow, David C. and Johnson, Miriam J. (2018) Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting. Journal of Palliative Medicine, 21 (1). pp. 37-43. ISSN 1557-7740 Haloperidol; Nausea; Palliative care; Pharmacovigilance; Symptom control; Vomiting https://doi.org/10.1089/jpm.2017.0159 doi:10.1089/jpm.2017.0159 doi:10.1089/jpm.2017.0159 |
| spellingShingle | Haloperidol; Nausea; Palliative care; Pharmacovigilance; Symptom control; Vomiting Digges, Madeline Hussein, Akram Wilcock, Andrew Crawford, Gregory B. Boland, Jason W. Agar, Meera R. Sinnarajah, Aynharan Currow, David C. Johnson, Miriam J. Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting |
| title | Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting |
| title_full | Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting |
| title_fullStr | Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting |
| title_full_unstemmed | Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting |
| title_short | Pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting |
| title_sort | pharmacovigilance in hospice/palliative care: net effect of haloperidol for nausea or vomiting |
| topic | Haloperidol; Nausea; Palliative care; Pharmacovigilance; Symptom control; Vomiting |
| url | https://eprints.nottingham.ac.uk/49227/ https://eprints.nottingham.ac.uk/49227/ https://eprints.nottingham.ac.uk/49227/ |