High exposure compared with standard exposure to metoclopramide associated with a higher risk of parkinsonism: a nationwide population-based cohort study
| Autor: | Rey Yue Yuan, Hsin Chien Lee, Shin Chia Tsai, Shiow Yunn Sheu, Li Nien Chien, Eunice Jia Shiow Yuan |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Pharmacology
medicine.medical_specialty Metoclopramide business.industry Parkinsonism Hazard ratio Case-control study Retrospective cohort study Pharmacoepidemiology medicine.disease Confidence interval 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Pharmacology (medical) 030212 general & internal medicine business 030217 neurology & neurosurgery medicine.drug Cohort study |
| Zdroj: | British Journal of Clinical Pharmacology. 84:2000-2009 |
| ISSN: | 0306-5251 |
| Popis: | Aims We conducted a cohort study utilizing a nationwide health insurance database to assess the European Medicines Agency's restrictions on using metoclopramide and its association with the risk of parkinsonism. Methods New oral metoclopramide users aged ≥20 years, and age- and gender-matched non-users were recruited between 2001 and 2011. Users were divided into high-exposure (dose >30 mg day-1 and/or duration >5 days) and standard-exposure (dose ≤30 mg day-1 and duration ≤5 days) groups. The adjusted hazard ratio (aHR) with 95% confidence interval (CI) estimated the risk of parkinsonism. Results During a 1-year period, 122 of 218 931 (0.06%) users of metoclopramide vs. 56 of 218 931 (0.03%) non-users developed parkinsonism (P Conclusions The risk of parkinsonism in metoclopramide users, although extremely low (0.06%), is 2.16-fold greater than in non-users. High-exposure users have a 1.83-fold higher risk than standard-exposure users. As users in high-exposure group had a higher risk of parkinsonism than in standard-exposure group, and the majority of users and parkinsonism in high-exposure group were from long-duration exposure; thus, physician are advised to avoid prescribing metoclopramide for >5 days, even if the daily dose is ≤30 mg. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text