Suppressive Effect by Pretreatment with Domperidone, Etizolam and Fluid Replacement of Adverse Reactions in Patients with a High-Risk of Side Effects Induced by Nonionic Contrast Media

Abstract

Our previous studies suggested that menopause and a preexisting abnormal renal function may be risk factors leading to an increased occurrence of adverse reactions to contrast media. The present prospective clinical study was carried out to examine the effect of pretreatment with domperidone, etizolam and fluid replacement on a reduction of adverse reactions induced by contrast media in patients with these risk factors.In 3009 patients undergoing a coronary angiography examination, a randomized and controlled trial was conducted from April 1, 1998 to March 31, 2000. Perimenopausal patients (n=732) were divided into two groups including: a post menopause group within 5 years (n=265) and over 5 years (n=467). Next, these two groups were further individually classified into two groups including: a domperidone and etizolam pretreated patient group (within 5 years; 132 patients, over 5 years; 233 patients) and a non-treated patient group (within 5 years; 133 patients, over 5 years; 234 patients). In addition, patients (n=83) with an abnormal renal function (serum creatinine level of 1.5 mg/mL or greater) were also divided into a pretreatment with fluid replacement group (42 patients) and a non-treatment group (41 patients).The overall incidence of adverse reactions of contrast media was 11.2%, and there were no serve or fatal adverse reactions. In female patients, the predominant adverse reactions included headache, vomiting, dizziness, glow and palpitations. Pretreatment with a combination of domperidone and etizolam suppressed the adverse reactions due to contrast media by 77% in post menopausal patients within five years. On the other hand, in postmenopausal patients (n=467) over five years, the pretreatment (n=233) did not effectively reduce the side effects of contrast media. In addition, in patients with an abnormal renal function, the incidence (16.7%) of adverse reactions in fluid replacement pretreatment-patients was significantly less than that (51.2%) in the non-treated patients.These results indicate that the pretreatment of patients with domperidone, etizolam and fluid replacement was found to successfully reduce the incidence of adverse reactions induced by contract media in patients with risk factors such as menopause and a preexisting abnormal renal function, respectively.