A retrospective chart review of opioid-induced nausea and somnolence on commencement for cancer pain treatment

Authors

  • Yoshiaki Okamoto, BP
  • Satoru Tsuneto, MD, PhD
  • Mamiko Tsugane, PhD
  • Tatsuya Takagi, PhD
  • Etsuko Uejima, PhD

DOI:

https://doi.org/10.5055/jom.2010.0041

Keywords:

opioid-induced nausea, opioid-induced somnolence, morphine, oxycodone, fentanyl, prochlorperazine, side effect, opioid

Abstract

Morphine, oxycodone, and fentanyl are major opioids available as controlledrelease morphine (CRM), controlled-release oxycodone (CRO), and transdermal fentanyl (TDF), respectively, in Japan. The authors conducted a retrospective chart review to examine (1) nausea and somnolence on commencement of CRM, CRO, and TDF for cancer pain treatment, (2) the antiemetic effectiveness of prochlorperazine to prevent opioid-induced nausea, and (3) the side effect of prochlorperazine on somnolence in patients with cancer pain. Four hundred thirteen patients with cancer were prescribed with CRM (N = 66), CRO (N = 196), and TDF (N = 151). The incidence of nausea on commencement of the TDF group (6.8 percent) was significantly lower than that of both the CRM group (22.6 percent) and the CRO group (35.4 percent; p < 0.001). There was no significant difference in the incidence of nausea on commencement of all groups combined with prochlorperazine at dosage of 15 mg/d. The incidence of somnolence on commencement of the TDF group (9.0 percent) was significantly lower than that of both the CRM group (31.3 percent) and the CRO group (41.5 percent; p < 0.001). The incidence of somnolence on commencement of the CRO group combined with prochlorperazine was significantly higher than that of the CRO combined without prochlorperazine (p < 0.05). In conclusion, the incidence of nausea and somnolence on commencement of TDF are significantly lower than that of both CRM and CRO for cancer pain treatment. Prochlorperazine at a dosage of 15 mg/d may not be effective in preventing opioid-induced nausea and may cause somnolence in patients with cancer pain.

Author Biographies

Yoshiaki Okamoto, BP

Associate Professor, Department of Hospital Pharmacy Education, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan.

Satoru Tsuneto, MD, PhD

Professor and Chair, Department of Palliative Medicine, Graduate School of Medicine, Osaka University, Osaka, Japan.

Mamiko Tsugane, PhD

Assistant Professor, Department of Hospital Pharmacy Education, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan.

Tatsuya Takagi, PhD

Professor, Division of Pharmacometrics and Pharmainformatics, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan.

Etsuko Uejima, PhD

Professor, Department of Hospital Pharmacy Education, Graduate School of Pharmaceutical Sciences, Osaka University, Osaka, Japan.

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Published

01/29/2018

How to Cite

Okamoto, BP, Y., S. Tsuneto, MD, PhD, M. Tsugane, PhD, T. Takagi, PhD, and E. Uejima, PhD. “A Retrospective Chart Review of Opioid-Induced Nausea and Somnolence on Commencement for Cancer Pain Treatment”. Journal of Opioid Management, vol. 6, no. 6, Jan. 2018, pp. 431-4, doi:10.5055/jom.2010.0041.