The final results of the preferred anti-emetic agent poll are in with ondansetron (69%) clearly more popular than metoclopramide (31%). Surprisingly, no-one voted for prochlorperazine or tropisitron.
The results are encouraging as ondansetron apppears to have a greater effect on nausea and vomiting from non migranous causes than metoclopramide, with fewer adverse effects. Metoclopramide is ineffective in paediatric gastroenteritis, but ondansetron may reduce ED LOS.
Previously ondansetron’s higher cost has been a factor in limiting it’s use, however the price (in large hospitals) is now only slightly more than that of metoclopramide, probably making it cost effective. However metoclopramide is safe in pregnancy, unlike the other agents. Prochlorperazine is probably less effective than ondansetron, but more effective than metoclopramide, however it is not licensed to be given IV (although it can be quite safely), which may limit it’s use.
Prochlorperazine or metoclopramide are probably the preferred agents for nausea (and headache) of suspected migrane.(link)
The poll is now closed.