Vogalene, Primperan… Anti-vomiting drugs would increase the risk of stroke

Taking anti-vomiting medications increases the risk of stroke.
Taking anti-vomiting medications increases the risk of stroke. (©Norman Awakening Files)

Vogalene, Primperan, Motilium… Taking these medications anti-vomiting, prescribed to millions of people each year, would increase the risk of ischemic stroke, that is, career linked to the occlusion of a cerebral artery by a blood clot.

This is the discovery made by researchers from Inserm, the University of Bordeaux and the University Hospital of Bordeaux, who published a study on the subject, this Thursday, March 24, 2022.

140,000 people a year suffer a stroke

To conduct their study, the researchers used a method of analyzing reimbursement data from Health insurance and those of hospital admissions for stroke, says a release Inserm (National Institute of Health and Medical Research).

Every year, 140,000 people suffer a stroke.most of which are ischemic strokes.

“The idea for the study comes from already established knowledge about antipsychotic neuroleptics that would increase the risk of stroke,” he says. actu.fr Antoine Pariente, professor at the Bordeaux University Hospital. He is one of three researchers who conducted the study.

We start from this principle to study the same effect with anti-vomiting drugs that are also neuroleptic.

Antoine KinsmanProfessor of Pharmacology at the University Hospital of Bordeaux

Risk multiplied by three

The researchers were able to analyze these data in 2,612 adults hospitalized for a first ischemic stroke who had taken these drugs in the 70 days prior to the stroke.

“We studied the association between the onset of a stroke and taking one of these drugs, observing whether use close to the time of stroke onset was more frequent than use more distant in the past.« continues Antoine Pariente.

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This made it possible to see that the risk of suffering a stroke was multiplied by three if the medication was taken approximately fifteen days before the accident.

Antoine KinsmanProfessor of Pharmacology at the University Hospital of Bordeaux

An observation shared by Inserm: “A stronger use in the period immediately before the accident is in favor of a role for the drug in the attack. »

To complete the analysis, the researchers “considered, over the same period, a random group of 21,859 people who had not had a stroke. In these people, a peak or excess use of antiemetics comparable to that shown in patients who have suffered a stroke has not been found”, continues Inserm.

no known cause

For now, we don’t know how to precisely explain the link between taking these drugs and stroke. “These drugs, which contain the same three active ingredients, everyone has property antidopaminergicit can be associated with that”, explains the professor of pharmacology and pharmacoepidemiology.

What is an antidopaminergic?

Antidopaminergics block the action of dopamine, a neurotransmitter involved, among other things, in the regulation of behavior, but also muscle tone and movement coordination, according to the Inserm definition.

“We also wonder about the effect of these drugs on blood flow patients, which could be a cause. But we are not sure of anything, these are just hypotheses”, Antoine Pariente advances cautiously.

Five million prescriptions a year

And yet these drugs, which are the main prescribed antiemetics, are used by five million people a year about “.

“Even if we are talking about a risk increased by three, the risk is initially low, so it will remain relatively low. But he is not zero. It’s a first sign. The study must be replicated with other data sets and other analysis methods to continue advancing on this topic and, in particular, to provide indications on the frequency of this adverse effect”, continues the Inserm researcher.

These medications are usually prescribed when vomiting-related complications. Namely, quite rare complications (blood ion concentration disorder, esophageal tear, etc.).

Therefore, the important thing is to further evaluate the risk/benefit ratio of prescribing these drugs, and ask ourselves if we are sure that the patient’s case is suitable for taking this type of pill.

Antoine KinsmanResearcher at Inserm and the University Hospital of Bordeaux

And as to whether certain risk factors or whether the personal characteristics of these patients would lead to an increased risk between taking anti-vomiting drugs and stroke, researchers still have no answer.

We cannot assess whether the body mass index, age or even smoking of these people favors the risk of stroke, because we do not have this information. And the sample size does not allow a fine examination of all situations.

Antoine KinsmanProfessor at the University Hospital of Bordeaux

Too early to question drugs

To date, no study has been published that evaluates this risk, says Inserm in its press release.

For now, it is too early to question the use of these drugs. But the truth is that each new knowledge of the risk of a drug must always raise the question of the benefits and risks of its prescription, to use them in favorable situations.

Antoine KinsmanResearcher at the University Hospital of Bordeaux

Unfortunately, like many medications, these are used for convenience. Keep in mind that all drugs carry risks.

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