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Anti-Nausea Drugs Implicated in Strokes?

We already knew that antipsychotics were associated with an increased risk of ischemic attack. Scientists believe that this risk also exists with antiemetics, drugs to fight against nausea and vomiting.

Some medications are known to have a potential side effect of an increased risk of ischemic stroke. This is particularly the case with antipsychotics, and this effect has been well known since the beginning of the 2000s. But another family of drugs could also have this harmful effect: these are antiemetics, in other words drugs that fight against nausea and vomiting, as explained by Inserm which relays a study.

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What makes antipsychotics responsible for stroke is thought to be their “antidopaminergic” property, i.e. which blocks the transmission of dopamine. Moreover, other drugs with this feature have also been shown to have a greater risk of stroke.

A new Inserm study shows that antiemetics (domperidone, metoclopramide and metopimazine, more commonly known under their trade names of Motilium, Primperan and Vogalene) which are prescribed for nausea and vomiting in the event of gastroenteritis, migraine, chemo, are other drugs which would present the same risk. “Those drugs are still used very commonly : in 2017 in France, more than 4 million people had had at least one reimbursement for metopimazine, the most used of them”, specifies Inserm.

Risks for whom and when?

To arrive at this idea, the researchers studied the reimbursement data of the Health Insurance and those of hospital admissions. Of course, they took into account each patient’s risk of stroke (tobacco, BMI, eating habits) and the medications taken before their accident. “2612 adults hospitalized for a first ischemic stroke, having started treatment with antiemetics in the 70 days preceding the ischemic stroke” were studied.

The risk is not the same for everyone, nor all the time”it increases with age and the presence of dementia“, notes Inserm. In addition, the risk would increase in the first days of taking medicationwhether antiemetic or antidopaminergic.

Source : Increased risk of ischemic stroke associated with certain drugs to relieve nausea and vomitingInserm, March 2022.

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