Skip to main content

Site navigation

  • University of Technology Sydney home
  • Home

    Home
  • For students

  • For industry

  • Research

Explore

  • Courses
  • Events
  • News
  • Stories
  • People

For you

  • Libraryarrow_right_alt
  • Staffarrow_right_alt
  • Alumniarrow_right_alt
  • Current studentsarrow_right_alt
  • Study at UTS

    • arrow_right_alt Find a course
    • arrow_right_alt Course areas
    • arrow_right_alt Undergraduate students
    • arrow_right_alt Postgraduate students
    • arrow_right_alt Research Masters and PhD
    • arrow_right_alt Online study and short courses
  • Student information

    • arrow_right_alt Current students
    • arrow_right_alt New UTS students
    • arrow_right_alt Graduates (Alumni)
    • arrow_right_alt High school students
    • arrow_right_alt Indigenous students
    • arrow_right_alt International students
  • Admissions

    • arrow_right_alt How to apply
    • arrow_right_alt Entry pathways
    • arrow_right_alt Eligibility
arrow_right_altVisit our hub for students

For you

  • Libraryarrow_right_alt
  • Staffarrow_right_alt
  • Alumniarrow_right_alt
  • Current studentsarrow_right_alt

POPULAR LINKS

  • Apply for a coursearrow_right_alt
  • Current studentsarrow_right_alt
  • Scholarshipsarrow_right_alt
  • Featured industries

    • arrow_right_alt Agriculture and food
    • arrow_right_alt Defence and space
    • arrow_right_alt Energy and transport
    • arrow_right_alt Government and policy
    • arrow_right_alt Health and medical
    • arrow_right_alt Corporate training
  • Explore

    • arrow_right_alt Tech Central
    • arrow_right_alt Case studies
    • arrow_right_alt Research
arrow_right_altVisit our hub for industry

For you

  • Libraryarrow_right_alt
  • Staffarrow_right_alt
  • Alumniarrow_right_alt
  • Current studentsarrow_right_alt

POPULAR LINKS

  • Find a UTS expertarrow_right_alt
  • Partner with usarrow_right_alt
  • Explore

    • arrow_right_alt Explore our research
    • arrow_right_alt Research centres and institutes
    • arrow_right_alt Graduate research
    • arrow_right_alt Research partnerships
arrow_right_altVisit our hub for research

For you

  • Libraryarrow_right_alt
  • Staffarrow_right_alt
  • Alumniarrow_right_alt
  • Current studentsarrow_right_alt

POPULAR LINKS

  • Find a UTS expertarrow_right_alt
  • Research centres and institutesarrow_right_alt
  • University of Technology Sydney home
Explore the University of Technology Sydney
Category Filters:
University of Technology Sydney home University of Technology Sydney home
  1. home
  2. arrow_forward_ios ... Newsroom
  3. arrow_forward_ios ... 2022
  4. arrow_forward_ios 08
  5. arrow_forward_ios Cyclizine for nausea | IMPACCT news

Cyclizine for nausea | IMPACCT news

18 August 2022

Nausea remains a significant problem for patients towards the end of life, regardless of the illness they have. There are a variety of drugs to treat nausea (antiemetics) available, but very little research to show which are most effective.

A man with short hair and a beard sits with his head resting on his hand. He is wearing a white t-shirt under a black jumper.

Key points:

  • This is the first study to examine real-world use of cyclizine in palliative care.
  • Approximately ¾ or patients benefit from cyclizine.
  • Around ⅓ of patients have tolerable side effects from cyclizine.
  • This is similar to other antiemetics in palliative care.

Choosing the right antiemetic

In many cases in medicine, clinical trials directly compare two different treatments to clearly demonstrate an advantage of one over the other. Unfortunately, no such trials exist for antiemetics – medications used to prevent or relieve nausea - in palliative care. So how do clinicians decide which of the many antiemetics are best for the patient in front of them?

A traditional method has been to choose based on the suspected cause of the nausea. There are theoretical reasons why some antiemetics might work better for some kinds of nausea than others. The problem is, this really is only theoretical. A trial conducted by the Palliative Care Clinical Studies Collaborative (PaCCSC) in 2018 showed no real difference in benefit between this approach and giving everyone the antiemetic haloperidol. 

In contemporary practice, many clinicians instead choose the antiemetic they perceive will cause the least side-effects. However, while the side-effects of most drugs are known at point of registration, which ones occur for individual patients depends on other factors such as what medical conditions they have, how sick they are, and which other drugs they are taking. This highlights another gap in palliative care research – the lack of good quality data on what side-effects patients in palliative care get from the same drugs used in other settings.

Pharmacovigilance in palliative care

Randomised controlled clinical trials are the best way of demonstrating one treatment is better than another. However, they are costly, and usually use a fixed dose of a drug in a narrow population. They aren’t good for understanding the effect of a drug in real-world patients. For this, we need prospective, observational studies – pharmacovigilance studies.

The IMPACCT Rapid Program has  52 series - 42 adult and 10 paediatric - that have collected or are currently collecting data about interventions in palliative care to understand both how well they work and what harm they do in the real world. These complement, rather than replace, randomised clinical trials.

Cyclizine and nausea

Cyclizine is one of the antiemetics available in Australia and around the world. Clinicians often worry about the side effects, and this is one reason it isn’t used first line for nausea in palliative care. However, there are no studies of patients in palliative care to understand the side-effect profile. We have now completed Rapid Program Series 12, Cyclizine for nausea. 

This series assessed 101 patients across 19 sites in Australia, New Zealand, and the UK. It showed that around three quarters of patients experienced benefit and around one third experienced harm. What’s interesting is that this is similar to other antiemetics used in palliative care. This means that clinicians may be seeing cyclizine as more harmful than it actually is, and that cyclizine remains a good option for selected patients in palliative care.

More studies are needed to directly compare different antiemetics, and to observe patients on treatment for longer.

The results of this trial are being presented pre-publication in the upcoming NSW Cancer Conference and will be published later this year.

 

 

Dr Richard McNeill has short hair and a beard and wearing a checked shirt. He is smiling at the camera.

Dr Richard McNeill is a palliative care physician and clinical pharmacologist in New Zealand. He is currently employed at Nurse Maude Hospice in Christchurch, and he is also a research fellow at the University of Otago. He is undertaking a masters in clinical informatics. Richard has an interest in research involving all aspects of pharmacotherapy in palliative care.


 

Byline

Dr Richard McNeill
Share
Share this on Facebook Share this on Twitter Share this on LinkedIn
Back to IMPACCT news

Related News

  • Young businessman in office wearing a play blue jumper over a white shirt. He has glasses on and he is smiling at the camera.
    IMPACCT Rapid Program - new user guides for simpler clinician participation
  • Clinician is examining a patient with back pain. The patient is a woman wearing a green t-shirt. She is sitting and the clinician's hands are on her back.
    NSAIDs for pain: are we underutilising a good analgesic?
  • Senior woman sits on the end of a bed clutching her abdomen. She is wearing white trousers and a cream coloured sleeveless top.
    Paracentesis for cancer-related ascites

Acknowledgement of Country

UTS acknowledges the Gadigal People of the Eora Nation and the Boorooberongal People of the Dharug Nation upon whose ancestral lands our campuses now stand. We would also like to pay respect to the Elders both past and present, acknowledging them as the traditional custodians of knowledge for these lands. 

University of Technology Sydney

City Campus

15 Broadway, Ultimo, NSW 2007

Get in touch with UTS

Follow us

  • Instagram
  • LinkedIn
  • YouTube
  • Facebook

A member of

  • Australian Technology Network
Use arrow keys to navigate within each column of links. Press Tab to move between columns.

Study

  • Find a course
  • Undergraduate
  • Postgraduate
  • How to apply
  • Scholarships and prizes
  • International students
  • Campus maps
  • Accommodation

Engage

  • Find an expert
  • Industry
  • News
  • Events
  • Experience UTS
  • Research
  • Stories
  • Alumni

About

  • Who we are
  • Faculties
  • Learning and teaching
  • Sustainability
  • Initiatives
  • Equity, diversity and inclusion
  • Campus and locations
  • Awards and rankings
  • UTS governance

Staff and students

  • Current students
  • Help and support
  • Library
  • Policies
  • StaffConnect
  • Working at UTS
  • UTS Handbook
  • Contact us
  • Copyright © 2025
  • ABN: 77 257 686 961
  • CRICOS provider number: 00099F
  • TEQSA provider number: PRV12060
  • TEQSA category: Australian University
  • Privacy
  • Copyright
  • Disclaimer
  • Accessibility