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myrtaryniel

myrtaryniel

Member
Mar 28, 2019
74
Is there any other antiemetic I could take instead? Primperan is very expensive in the black market and I don't have the money...Also don't think I could trick my doctor into anything
 
H

Honigwaffel

Student
Apr 9, 2019
154
There are a few alternatives to meto (Primperan) like Domperidone, Ondansetron. However I doubt that they will be any cheaper to be honest.
 
Last edited:
B

Bentham

Member
Feb 21, 2019
45
There are a few alternatives to meto (Primperan) like Domperidone, Ondansetron or Mosapride. However I doubt that they will be any cheaper to be honest.

Sorry for my English, I think several people understand my statement in a way different from what I intended.

Domperidone + Ondansetron + Mosapride would theoretically be an alternative to Meto. Meto has three distinct features: D2 and 5-HT3 antagonism, and 5-HT4 agonism.
Domperidone: D2 antagonist but less BBB passing ability than other D2 blockers, meaning less EPS and tardive dyskinesia. D2 antagonist role to prevent NV is thought to be played at CTZ located outside the BBB.
Ondansetron: 5-HT3 antagonist, which also prevent nausea and vomiting (NV) by blocking a 5-HT3 activity mainly at intestine.
Mosapride: 5-HT4 agonist, which accelerates gastric emptying, and to a lesser extent 5-HT3 antagonist. But they are available mainly in Asian countries.

I don't think there is any evidence about which antagonist (D2 or 5-HT3) has a central preventive effect on SN induced NV, so it's safe to say both antagonists are needed.

edit: D2 antagonist also acts at upper GI tract as accelerating gastric emptying.

The combination of Domperidone + Ondansetron + Mosapride together is a theoretical altanative, not either of them.
 
H

Honigwaffel

Student
Apr 9, 2019
154
The combination of Domperidone + Ondansetron + Mosapride together is a theoretical altanative, not either of them.
If you want the exact same way that meto works, yes absolutely. From my understanding Meto is definitely the best anti emetic to use because it acts very strong. Since anti emetics are not 100% needed (Although recommended) for this method, one might be fine using a less strong anti emetic like domperidone for example. So it can be an alternative. Even some OTC drugs, that are less effectiv, are technically alternatives if you compare it to using no anti emetics at all.
 
W

whatever1111

Student
Feb 16, 2019
195
If you want the exact same way that meto works, yes absolutely. From my understanding Meto is definitely the best anti emetic to use because it acts very strong. Since anti emetics are not 100% needed (Although recommended) for this method, one might be fine using a less strong anti emetic like domperidone for example. So it can be an alternative. Even some OTC drugs, that are less effectiv, are technically alternatives if you compare it to using no anti emetics at all.
sorry for asking for the milionth time, but since the thread exists - with 48h meto regime, and some fasting - how long would it take for the SN to be absorbed? is then puking a minimal problem?
 
B

Bentham

Member
Feb 21, 2019
45
If you want the exact same way that meto works, yes absolutely. From my understanding Meto is definitely the best anti emetic to use because it acts very strong. Since anti emetics are not 100% needed (Although recommended) for this method, one might be fine using a less strong anti emetic like domperidone for example. So it can be an alternative. Even some OTC drugs, that are less effectiv, are technically alternatives if you compare it to using no anti emetics at all.
I wanted people to know that Mosapride is not an anti-emetic but prokinetic, which must not be regarded as an alternative to meto or other antiemetics. Further, Ondansetron (5ht3 antagonists) is widely used as one of the first choice antiemetics for CINV and PONV, but the mechanism of its actions is different from D2 antagonists. D2 antagonists, for example, are effective for apomorphine or copper sulfate, but 5ht3 antagonists are not. The problem is that we do not know which antagonistic feature(s) has antiemetic effect on this particular substance of SN.
 
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H

Honigwaffel

Student
Apr 9, 2019
154
I wanted people to know that Mosapride is not an anti-emetic but prokinetic, which must not be regarded as an alternative to meto or other antiemetics. Further, Ondansetron (5ht3 antagonists) is widely used as one of the first choice antiemetics for CINV and PONV, but the mechanism of its actions is different from D2 antagonists. D2 antagonists, for example, are effective for apomorphine or copper sulfate, but 5ht3 antagonists are not. The problem is that we do not know which antagonistic feature(s) has antiemetic effect on this particular substance of SN.
Thanks for clarifying!
 
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