18.104.22.168 Opioid-induced (not palliative care)
|1st choices||Cyclizine tablets 50mg; injection 50mg/ml||Dose:|
Orally or by intramuscular or intravenous injection, 50mg up to three times daily
|Prochlorperazine tablets 5mg; syrup 5mg/ml; buccal tablets 3mg; injection 12.5mg/ml;||Dose:|
Acute attack, 20mg then 10mg after 2 hours; prevention 5-10mg 2-3 three times daily
Buccal tablets, 1-2 tablets twice daily
By deep intramuscular injection, 12.5mg when required followed if necessary after 6 hours by oral dose, as above
- Surgical patients receiving morphine should be prescribed prophylactic anti-emetics such as cyclizine or prochlorperazine.
- Patients suffering an acute myocardial infarction should be given intravenous morphine or diamorphine; an antiemetic such as metoclopramide should be given concomitantly.
Nausea and vomiting associated with cytotoxic chemotherapy
See chapter 8 of the BNF.
Nausea and vomiting in palliative care
See palliative care section of the BNF.