Antidopaminergic antiemetics (ADAs) are commonly prescribed drugs to relieve nausea and vomiting caused by migraine, chemotherapy, or radiotherapy.
In a new study, researchers found that these drugs are linked to an increased risk of ischaemic stroke.
All three ADAs drugs in the study (domperidone, metopimazine, and metoclopramide) were linked to an increased risk of stroke, especially in the first days of use.
The highest increase of stroke risk was found for metopimazine and metoclopramide.
Like antipsychotics, ADAs are antidopaminergic drugs—they work by blocking dopamine activity in the brain.
Antipsychotics have been associated with an increased risk of ischaemic stroke, but whether this risk could extend to other antidopaminergics including ADAs is not known.
To estimate the risk of stroke linked to antidopaminergic antiemetic, researchers found 2,612 patients from the nationwide French reimbursement healthcare system database (SNDS) .
Patients had an average age of 72 years and 34% were men.
Researchers compared frequencies of these ADA reimbursements between a risk period and three matched reference periods.
Patients with stroke were then matched by age, sex, and stroke risk factors to a healthy control group of 21,859 randomly selected people who also received an ADA in the same time period.
Among patients with stroke, 1,250 received an ADA at least once in the risk period and 1,060 in the reference periods.
Among the control group, 5,128 and 13,165 received an ADA at least once in the risk and reference periods, respectively.
Researchers found that new users of ADA could be at a 3-fold increased risk of a stroke shortly after treatment started.
Further analyses by age, sex, and history of dementia showed similar results, with men at the highest (a 3.59-fold increased) risk.
The risk appeared to increase for all ADAs, the highest increase being found for metopimazine (a 3.62-fold increase) and metoclopramide (a 3.53-fold increase), both of which are drugs that cross the blood-brain barrier.
The findings suggest that the risk of ischaemic stroke appears to be associated with ADA use.
The researchers suggest that the potential action of ADAs on blood flow to the brain may explain this higher risk.
Sign up for our newsletter for more information about this topic.
If you care about stroke, please read studies about how to control your cholesterol effectively to prevent heart attacks and strokes, and this inexpensive drug combo can protect your heart health, prevent stroke.
For more information about stroke, please see the recent case at 27, she collapsed in the shower from a stroke, and results show this combo therapy can cut the risk of heart attack and stroke by half.
The study was conducted by A Bénard-Laribière et al., and published in British Medical Journal.
