An interventional study of Metoclopramide and Diphenhydramine in Headache, sponsored by St. Louis University. Completed at 1 site in United States. Open to female participants aged 16 Years to 50 Years. Per ClinicalTrials.gov, last updated 2018-04-02.
Sponsored by St. Louis University · Not applicable, Interventional, and Prevention
To determine if the intravenous administration of Metoclopramide and diphenhydramine in combination can effectively treat headaches in pregnant patients in those refractory to acetaminophen when compared to codeine
This is a randomized, controlled study based on prospective collection of data during the study subjects' hospital stays, questioning at 30 minutes and 1, 6, and 24 hours after administration, and a post-study questionnaire at 24 hours. Subjects who agree to participate in the study will have already tried a standard effective dose of acetaminophen (650 to 1000mg) without relief and are requesting further medication. Intravenous (IV) access will be obtained and administration of 10mg Metoclopramide IV and 25mg Diphenhydramine IV drawn up in the same syringe will be given to subjects randomized to Group A, while those randomized to Group B (control group) will receive standard treatment consisting of a codeine 30mg tablet. Each subject will be asked if they had relief or persistence/recurrence of symptoms at 30 minutes, 1 hour and 6 hours after initial receipt of study medications. An additional dose of 10 mg IV metoclopramide + 25 mg IV diphenhydramine or codeine 30 mg tablets would be given at one hour if the patient did not have adequate relief the first time. If headache does not subside or recurs after second dose, regular non protocol medicines may be administered upon doctor recommendation. Patients will again be asked about headache at 24 hours and asked to complete a questionnaire regarding tolerance of medication, any adverse reactions experienced, persistence/recurrence of headache after administration of study medication, timing of occurrence with regard to administration, requirements of a second dose of study medication or other use of headache or nausea medication not included in protocol, satisfaction or relief of headache on a Likert scale from 0 to 10 after administration of medication if given at 1 hr interval.
Randomization Subjects will be randomized to GROUP A or GROUP B. An order will be placed to the SMHC pharmacy for the respective Group and will send up the medication assigned. The pharmacy will know which medications are in Group A and which are in Group B. On the pharmacy order sheet, the research team will indicate which group each subject is randomized to. The pharmacy will supply the medications and one of the nurses on the 5th floor will administer them.
1,226 studies on the registry are indexed under Headache; 202 are open to participants now.
This study's enrollment of 70 is above the median of 60 across 918 interventional studies indexed under Headache.
Browse Headache studies →St. Louis University is the lead sponsor of 152 studies on the registry; 17 are open to participants now.
Of its 19 completed or terminated interventional studies of FDA-regulated products, 15 (79%) have results posted.
Counted across the registry records on this site, refreshed daily.
Pregnant women age 16 or older, admitted to the hospital or treated in the triage unit at 14 weeks gestation or greater, with subjective symptoms of persistent headache despite 650-1000 mg acetaminophen taken more than one hour before administration of study medication.
Exclusion Criteria:
Treatment with another headache-aborting medication other than acetaminophen within 24 hours Allergy to metoclopramide, diphenhydramine, or codeine Systolic blood pressure >/= 140 Diastolic blood pressure >/= 90 History of brain tumor Active diagnosis of hyperemesis Acute asthma exacerbation at time of presentation Active labor
Intravenous (IV) access will be obtained and administration of 10mg Metoclopramide IV and 25mg Diphenhydramine IV Group A
Drug: Metoclopramide · Drug: Diphenhydramine
Group B (control group) will receive standard treatment consisting of a codeine 30mg tablet.
Drug: Codeine
IV
Also known as: metoclopramide, Reglan, Reglan ODT, Metozol ODT, Octamide,
iv
Also known as: Benadryl
PO
Number of Participants With Adequate Relief of Headache as a Measure of Efficacy
Number of participants with reduction in pain scores six hours post administration by at least 2 on the pain score scale.
Time frame: Primary outcome was six hours post administration
This was a prospective randomized, controlled trial at a single perinatal care center, conducted from December 2012 through September 2014 and approved by the IRB at Saint Louis University.
| Milestone | Metoclopramide IV & Diphenhydramine IV | Codeine |
|---|---|---|
| Started | 35 | 35 |
| Completed | 35 | 34 |
| Not completed | 0 | 1 |
| Withdrew: Adverse event | 0 | 1 |
Number of participants with reduction in pain scores six hours post administration by at least 2 on the pain score scale.
| Participants | Metoclopramide IV & Diphenhydramine IV | Codeine |
|---|---|---|
| Number of Participants With Adequate Relief of Headache as a Measure of Efficacy | 34 | 32 |
Collected over 24 hours. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Metoclopramide & Diphenhydramine | 0/35 (0%) | 0/35 (0%) | 0/35 (0%) |
| Codeine | 0/35 (0%) | 0/35 (0%) | 0/35 (0%) |
Baseline demographic characteristics were similar between the two groups.
| Age, Customized(Participants) | Metoclopramide IV & Diphenhydramine IV | Codeine | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 35 | 34 | 69 |
| >=65 years | 0 | 0 | 0 |
| Age, Continuous(years) | Metoclopramide IV & Diphenhydramine IV | Codeine | Total |
|---|---|---|---|
| Median | 23 (21 to 25) | 23.5 (21 to 27) | 23 (21 to 27) |
| Sex: Female, Male(Participants) | Metoclopramide IV & Diphenhydramine IV | Codeine | Total |
|---|---|---|---|
| Female | 35 | 34 | 69 |
| Male | 0 | 0 | 0 |
| Region of Enrollment(participants) | Metoclopramide IV & Diphenhydramine IV | Codeine | Total |
|---|---|---|---|
| United States | 35 | 34 | 69 |
Plan to share: No
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St. Louis University