8 6 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 1 8
We soon could have some promising therapeutic options to pre-
vent and treat post-operative nausea and vomiting (PONV). Here's
a review.
• Amisulpride. Remember droperidol, the popular dopamine-
blocking drug the FDA slapped a blackbox warning on in 2001
because it caused irregular heart rhythms? Sanofi-Aventis hopes
next year to launch amisulpride, said to be similar to droperidol,
but without a significant risk of QT prolongation at the dosage it
was used in studies. Researchers concluded a low dose of IV
amisulpride is safe and effective in preventing PONV when given in
combination with an anti-nausea drug from another class to high-
risk adult patients undergoing elective procedures under inhala-
tional general anesthesia. It's also shown effectiveness as a res-
cue measure for when nausea occurs. Amisulpride is currently
under review by the FDA. Amisulpride has been used orally — in
much larger doses than the IV dose used to prevent PONV — in
European patients for 30 years to treat schizophrenia.
• Korsuva. A drug that can treat pruritus, pain … and PONV? A
funny thing happened when Cara Therapeutics studied Korsuva
(CR845/difelikefalin), a kappa-opioid receptor agonist, as a non-
opioid post-op pain relief drug. Yes, it worked against pain without
the possibility of abuse and addiction, but IV CR845 treatment was
also shown to be effective as an antiemetic for PONV. And, yes, it
also reduces severe itching in patients suffering from chronic kid-
ney disease and on dialysis. We could see it in 2020.
• Oliceridine. Last month, an FDA advisory committee voted 8-7
against recommending approval of oliceridine, a mu opioid recep-
NEW ANTIEMETICS
3 PONV Drugs in the Pipeline
