Scottish Palliative Care Guidelines
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| Receptor site affinities of selected anti-emetics | |||||||||
| D2 antagonist | H1 antagonist | Muscarinic antagonist | 5HT2 antagonist | 5HT3 antagonist | NK1 antagonist | 5HT4 agonist | CB1 agonist | GABA mimetic | |
| Domperidone1 | ** | ||||||||
| Haloperidol | *** | */- | |||||||
| Metoclopramide2 | ** | * | ** | ||||||
| Cyclizine | ** | ** | |||||||
| Hyoscine Hydrobromide |
*** | ||||||||
| Chlorpromazine | *** | *** | ** | ** | |||||
| Levomepromazine | ** | *** | ** | *** | |||||
| Olanzapine | ** | * | ** | ** | * | ||||
| Prochlorperazine | *** | ** | * | */** | |||||
| Promethazine | */** | ** | ** | ||||||
| Lorazepam | *** | ||||||||
| Nabilone | *** | ||||||||
| Aprepitant | *** | ||||||||
| Ondansetron/ Granisetron3 | *** | ||||||||
Pharmacological activity: blank = none or insignificant; * = slight; ** = moderate; *** = marked.
1domperidone: does not normally cross the blood-brain barrier; minimal risk of extrapyramidal effects, watch for interactions.
2metoclopramide: caution in use of prolonged higher doses, monitor for extrapyramidal side effects.
3ondansetron/granisetron: consider interactions
Adapted from Twycross, R, Wilcock, A and Howard, P (eds) Palliative Care Formulary 5th Edition 2014.
