Metoclopramide (only in absence of colic): 30-100mg/24hr
or
Haloperidol: 2.5mg–5mg/24hr
and/or
Cyclizine: 75mg–100mg/24hr
Metoclopramide (only in absence of colic): 30-100mg/24hr
or
Haloperidol: 2.5mg–5mg/24hr
and/or
Cyclizine: 75mg–100mg/24hr
Hyoscine butylbromide: 60mg–120mg/24hr (higher doses have been used up to 300mg)
Glycopyrronium: 600 micrograms –1.2 mg/24hr
Strong opioid may be continued via a non-oral route.
Titrate/convert according to pain “requirements”
1. Hyoscine butylbromide:
60mg–120mg/24hr (higher doses have been used up to 300mg).
Or
2. Octreotide 2nd line (if hyoscine butylbromide ineffective with specialist advice):
500 microgram / 24hr initially. Can be increased to 750 micrograms/24hrs if necessary.
If ineffective stop after 48 hours.
If octreotide is effective titrate to lowest effective dose.
Can add:
3. A three day trial of 5HT3 – receptor antagonists:
e.g. Ondansetron or granisetron.