Resource 50 mg of Meto before SN might make 46% of people not vomit and it poses no adverse side effects according to study with cancer patients

[quiet.rabbit]

Edit: This study is outdated as it is from 1986, and not valid either way (check out Weary's reply below) . Still, I will look for more recent research and update with what I find.
I am deeply sorry.

Three times 50 mg metoclopramide (with or without prednisone) four hours apart during one cytostatic-drug cycle was well tolerated by patients in both groups and can be recommended as a simple, practical prophylaxis of nausea and vomiting in the course of strongly emetogenic treatment of cancer.

Complete absence of vomiting was obtained in 52% of cycles in group A, 46% of cycles in group B.

Source: https://pubmed.ncbi.nlm.nih.gov/3510848/

We are looking at Group B since they are the ones only taking Meto. According to this 50 mg of Meto would reduce chances of vomiting even more with no adverse effects so that 46% of people don't vomit at all, from what I understood.

Wouldn't this work better for SN instead of the current dosage advised by Stan's guide? Since these cancer patients are taking drugs that, like SN, trigger the body's vomiting reaction strongly enough to make most vomit even at lower doses of meto and it states it is safe to take that much meto I think it's a question worth asking.

I'm not an expert though so if any of you have research that counters this please let me know.

 

[checkouttime]

The only think i can think of where there might be differences, is that taking more meto could increase the chances of side effects from it. You can find conflicting evidence wherever you look really, i mean stan's guide says take 30mg 45mins before, wheres pph says 30mg 1hr before. Stan's guide says don't use an anti travel sickness one , the pph says its fine to use dramamine as an anti e, if others aren't available!!! It says at one point use it 1hr before then in a table 30mins before lol.I personally have dramamine, but i am using N, not SN. which will be alot different.

I'm sticking with whats in the PPH personally

 

[quiet.rabbit]

The only think i can think of where there might be differences, is that taking more meto could increase the chances of side effects from it. You can find conflicting evidence wherever you look really, i mean stan's guide says take 30mg 45mins before, wheres pph says 30mg 1hr before. Stan's guide says don't use an anti travel sickness one , the pph says its fine to use dramamine as an anti e, if others aren't available!!! It says at one point use it 1hr before then in a table 30mins before lol.I personally have dramamine, but i am using N, not SN. which will be alot different.

I'm sticking with whats in the PPH personally

Yes, but the study points out that this doesn't increase by a lot and is still safe.

Also just wanted to point out that the PPeH says that Dramamine is ok as long at it has Meclizine as an active ingredient which also blocks dopamine receptors like Meto. It just isn't as potent, so it still is better than nothing. Here is where I found that out:

It is an antagonist at histamine H1, dopamine D2, and muscarinic cholinergic receptors. Its central anticholinergic and antihistaminic effects cause inhibition of the chemoreceptor trigger zone associated with the vomiting center Ebadi (1998).

Source: https://www.sciencedirect.com/topics/medicine-and-dentistry/meclizine#:~:text=It is an antagonist at,vomiting center Ebadi (1998)

And you can take Me to 30 mins or an hour before if you want. Meto can take from 30 mimutes to 1 hour to take effect, so both are not really wrong. Depends on how good your body is at absorbing it.

 

[checkouttime]

Yes, but the study points out that this doesn't increase by a lot and is still safe.

Also just wanted to point out that the PPeH says that Dramamine is ok as long at it has Meclizine as an active ingredient which also blocks dopamine receptors like Meto. It just isn't as potent.
Source: https://www.sciencedirect.com/topics/medicine-and-dentistry/meclizine#:~:text=It is an antagonist at,vomiting center Ebadi (1998)

And you can take Me to 30 mins or an hour before if you want. Meto can take from 30 mimutes to 1 hour to take effect, so both are not really wrong.

Ah rite, sorry i didn't read the actual article.

In the march 2021 PPH it doesn't mention anything about dramamine having meclizine in it???



I'm not to worried about using an anti e with N personally, plenty of people haven't. When my method was using SN i wasn't going to bother using an anti e to be fair, a few discussed it last year. We came to the conclusion the important thing was having more than one dose, and not being found. I think there is like one recorded case of a person not being sick when taking SN, a thread with a list and all the info was made actually

 

[quiet.rabbit]

Ah rite, sorry i didn't read the actual article.

In the march 2021 PPH it doesn't mention anything about dramamine having meclizine in it???

View attachment 69892

I'm not to worried about using an anti e with N personally, plenty of people haven't. When my method was using SN i wasn't going to bother using an anti e to be fair, a few discussed it last year. We came to the conclusion the important thing was having more than one dose, and not being found. I think there is like one recorded case of a person not being sick when taking SN, a thread with a list and all the info was made actually

Huh. That's odd... I remember having read it but now that I've checked my earlier copy I don't see meclizine in there either. Maybe I have it in one of the editions in my other device so I'll update later.

Would you mind providing the link to that thread? I think that meto is important since it's also used to increase the rate at which food is digested which could help getting more of the SN into the blood quicker and also prevents you from vomiting out part of the SN solution. The SN method is all about overpowering your body's natural ability to convert methemoglobin into hemoglobin, and the more SN there is in the blood the more metHb will be produced. All this would increase the chances of getting a fatal level of metHb in the blood and make a great difference for people whose bodies happen to be more efficient at converting it into Hb.

 

[checkouttime]

Huh. That's odd... I remember having read it but now that I've checked my earlier copy I don't see meclizine in there either. Maybe I have it in one of the editions in my other device so I'll update later.

Would you mind providing the link to that thread? I think that meto is important since it's also used to increase the rate at which food is digested which could help getting more of the SN into the blood quicker and also prevents you from vomiting out part of the SN solution. The SN method is all about overpowering your body's natural ability to convert methemoglobin into hemoglobin, and the more SN there is in the blood the more metHb will be produced. All this would increase the chances of getting a fatal level of metHb in the blood and make a great difference for people whose bodies happen to be more efficient at converting it into Hb.

they do a non drowsy version that contains meclizine? think its called all day. although the picture in the latest version is of the original version.

I can't remember the thread, i just remember it being discussed alot at the time and a few of us were happy not using it. You only need to absorb a small of SN compared to what you ingest for it to be lethal, so if you aren't found and have more cups of SN you would still CTB.

The meto is to stop you from being sick. It is recommended to use a H2 antagonist(Tagamet) or PPI (Nexium) to reduce stomach acid so the SN is absorbed quicker. there is also a drug called propranolol that can potentiate the method aswell.

 

[Weary Soul]

Personally, I would be careful extrapolating too much from this abstract for a couple of reasons.

From what they wrote in the conclusion of the abstract, it appears that the antiemetic effect was measured after total administration of 150 mg, with administration of 50 mg predose and 100 mg postdose (2 x 50 mg), and not after a single 50 mg dose administered after the cisplatin. Therefore it is unknown if a 50 mg dose given after cisplatin administration would actually work to decrease nausea and vomiting. And please know that I am in no way suggesting that anyone should take 150 mg meto.

Also, I would be cautious about their comment that it was "well-tolerated." These are cancer patients, not realtively healthy patients so the standard of what is considered tolerable is different. Sadly, it is common that people in this patient population (ie, those who receive chemo) oftentimes experience terrible side effects so unless the side effects observed during the study were especially severe or novel, they will typically use the phrase "generally well-tolerated." Here they used "well-tolerated." But without an actual list of adverse and serious adverse events - I would hesitate to take this phrase at face value.

I have to add that I am only going by what I read in the abstract. Without seeing the full article it is really difficult to determine exactly what happened during the study and how they came to these conclusions.

On edit: I just checked the date on this study. It was conducted in 1986. Research has come a long way since then.

 

[quiet.rabbit]

they do a non drowsy version that contains meclizine? think its called all day. although the picture in the latest version is of the original version.

I can't remember the thread, i just remember it being discussed alot at the time and a few of us were happy not using it. You only need to absorb a small of SN compared to what you ingest for it to be lethal, so if you aren't found and have more cups of SN you would still CTB.

Yeah that's the one, and in the version I was looking at they also had that picture but the text said meclizine. Ig they just messed up or something. It still does seem like a promising alternative though.

You might pass out before you can drink the second dose. Although vomiting doesn't necessarily mean failiure, Meto still increases the amount of metHb which makes CTB quicker and increases the chances of success, while also reducing nausea and vomiting. It's worth trying to obtain especially since online pbarmacies sell it pretty cheap. My Meto actually cost me less than the Tagamet. All you have to do is ask around. When it comes to CTB I think maximizing your chances of success in however many attempts you make is important.

The meto is to stop you from being sick. It is recommended to use a H2 antagonist(Tagamet) or PPI (Nexium) to reduce stomach acid so the SN is absorbed quicker. there is also a drug called propranolol that can potentiate the method aswell.

You're not wrong about the other drugs, but Meto also facilitates the absorption of SN. I don't know where you got that but I found this:

Metoclopramide is in a class of medications called prokinetic agents. It works by speeding the movement of food through the stomach and intestines.

Source: https://medlineplus.gov/druginfo/meds/a684035.html#:~:text=Metoclopramide is used to relieve,of the esophagus) that did

Antiacids help SN pass through stomach. After the SN leaves the stomach, Meto helps it get absorbed through the intestines.

Personally, I would be careful extrapolating too much from this abstract for a couple of reasons.

From what they wrote in the conclusion of the abstract, it appears that the antiemetic effect was measured after total administration of 150 mg, with administration of 50 mg predose and 100 mg postdose (2 x 50 mg), and not after a single 50 mg dose administered after the cisplatin. Therefore it is unknown if a 50 mg dose given after cisplatin administration would actually work to decrease nausea and vomiting. And please know that I am in no way suggesting that anyone should take 150 mg meto.

Also, I would be cautious about their comment that it was "well-tolerated." These are cancer patients, not realtively healthy patients so the standard of what is considered tolerable is different. Sadly, it is common that people in this patient population (ie, those who receive chemo) oftentimes experience terrible side effects so unless the side effects observed during the study were especially severe or novel, they will typically use the phrase "generally well-tolerated." Here they used "well-tolerated." But without an actual list of adverse and serious adverse events - I would hesitate to take this phrase at face value.

I have to add that I am only going by what I read in the abstract. Without seeing the full article it is really difficult to determine exactly what happened during the study and how they came to these conclusions.

On edit: I just checked the date on this study. It was conducted in 1986. Research has come a long way since then.

Oh crap!!! I was so excited I didn't even notice .

Let me edit the OP real quick.

 

[pthnrdnojvsc]

Edit: This study is outdated as it is from 1986, and not valid either way (check out Weary's reply below) . Still, I will look for more recent research and update with what I find.
I am deeply sorry.



Source: https://pubmed.ncbi.nlm.nih.gov/3510848/

We are looking at Group B since they are the ones only taking Meto. According to this 50 mg of Meto would reduce chances of vomiting even more with no adverse effects so that 46% of people don't vomit at all, from what I understood.

Wouldn't this work better for SN instead of the current dosage advised by Stan's guide? Since these cancer patients are taking drugs that, like SN, trigger the body's vomiting reaction strongly enough to make most vomit even at lower doses of meto and it states it is safe to take that much meto I think it's a question worth asking.

I'm not an expert though so if any of you have research that counters this please let me know.

This is a good find. I don't see why because it's from 1986 makes it a bad study . The year doesn't matter. i think it's a good study / experiment and it confirms what i myself theorized why not more than 30 mg meto.

i guess i can always test it myself and see how i tolerate 30 mg Meto first and than if that goes good i could try to test 40mg and see how it goes of course i won't try SN then just maybe a half teaspoon of regular salt. i already take a half teaspoon of regular salt as that is a needed electrolyte and also good practice for me for SN.

Also what you say about meto is also true that it empties the stomach quicker so it speeds up helps the absorption of SN.

The year doesn't matter: Watson and Crick's research in 1953 discovered the Structure of DNA "they found the secret of life" . so do we say that's old research because it's from 1953 ? No that's one of the greatest discoveries in the history of the world.

The Day Scientists Discovered the 'Secret of Life'

Medical historian Dr. Howard Markel revisits moments that changed the course of modern medicine. The place: The Eagle, a genial pub and favorite luncheon spot for the staff, students and researchers working at the University of Cambridge's old Cavendish laboratory on nearby Free School Lane. The...

www.pbs.org

Likewise imo Charles Darvwin discovered the theory of evolution in 1859 in the book the origin of species. That's not old but the greatest discovery imo . It tells me what a human is ,where did i originate, what am i, what is life and how did life originate. Both of these studies/experiments/conclusions have stood the test of time and are the truth and are imo the 2 greatest discoveries of all time.

On the Origin of Species - Wikipedia

en.wikipedia.org

i guess i can always test it myself and see how i tolerate 30 mg first and than if that goes good i could try to test 40mg and see how it goes of course i won't try SN then just maybe a half teaspoon of regular salt. i already take a half teaspoon of regular salt as that is a needed electrolyte and also good practice for me for SN.

Weird Science: Salt is Essential to Life | manoa.hawaii.edu/ExploringOurFluidEarth

manoa.hawaii.edu

How Much Sodium (Salt) Is Too Much for My Heart? | Ro

Many popular restaurant foods are high in sodium, along with grocery items you might not expect, like bread and canned vegetables.

www.getroman.com

We can keep going back in time, Newton's Principia in 1687 and so on . the year doesn't matter.

 

[Anonymoussn]

Interesting thread here:

https://sanctioned-suicide.net/thre...m-as-a-cause-of-sn-failure.47986/#post-865985

Essentially, the vomiting effect of SN doesn't actually appear to make failure any more likely. I can certainly appreciate that not vomiting might make your experience more comfortable. Perhaps even it might make you less likely to call for help. But people don't fail as a result of vomiting soon after taking SN - or at least that hasn't been a thing from the case studies we have seen on here. So I'm questioning whether there is even much point having Meto.

 

[checkouttime]

Interesting thread here:



Essentially, the vomiting effect of SN doesn't actually appear to make failure any more likely. I can certainly appreciate that not vomiting might make your experience more comfortable. Perhaps even it might make you less likely to call for help. But people don't fail as a result of vomiting soon after taking SN - or at least that hasn't been a thing from the case studies we have seen on here. So I'm questioning whether there is even much point having Meto.

that was one of the threads we discussed last year that i was talking about!! there is a list of cases and what happened in each circumstance! quite a few of us questioned if meto was needed and a few have ctb without using it, i can't remember the name of the last member it was the lad from sweden i think. he never used any meto.

 

[Weary Soul]

This is a good find. I don't see why because it's from 1986 makes it a bad study . The year doesn't matter. i think it's a good study / experiment and it confirms what i myself theorized why not more than 30 mg meto.

i guess i can always test it myself and see how i tolerate 30 mg Meto first and than if that goes good i could try to test 40mg and see how it goes of course i won't try SN then just maybe a half teaspoon of regular salt. i already take a half teaspoon of regular salt as that is a needed electrolyte and also good practice for me for SN.

Also what you say about meto is also true that it empties the stomach quicker so it speeds up helps the absorption of SN.

The year doesn't matter: Watson and Crick's research in 1953 discovered the Structure of DNA "they found the secret of life" . so do we say that's old research because it's from 1953 ? No that's one of the greatest discoveries in the history of the world.

The Day Scientists Discovered the 'Secret of Life'

Medical historian Dr. Howard Markel revisits moments that changed the course of modern medicine. The place: The Eagle, a genial pub and favorite luncheon spot for the staff, students and researchers working at the University of Cambridge's old Cavendish laboratory on nearby Free School Lane. The...

www.pbs.org

Likewise imo Charles Darvwin discovered the theory of evolution in 1859 in the book the origin of species. That's not old but the greatest discovery imo . It tells me what a human is ,where did i originate, what am i, what is life and how did life originate. Both of these studies/experiments/conclusions have stood the test of time and are the truth and are imo the 2 greatest discoveries of all time.

On the Origin of Species - Wikipedia

en.wikipedia.org

i guess i can always test it myself and see how i tolerate 30 mg first and than if that goes good i could try to test 40mg and see how it goes of course i won't try SN then just maybe a half teaspoon of regular salt. i already take a half teaspoon of regular salt as that is a needed electrolyte and also good practice for me for SN.

Weird Science: Salt is Essential to Life | manoa.hawaii.edu/ExploringOurFluidEarth

manoa.hawaii.edu

How Much Sodium (Salt) Is Too Much for My Heart? | Ro

Many popular restaurant foods are high in sodium, along with grocery items you might not expect, like bread and canned vegetables.

www.getroman.com

We can keep going back in time, Newton's Principia in 1687 and so on . the year doesn't matter.

Respectfully, I disagree.

The year does matter when it comes to drug studies. The discovery of DNA, antibiotics, gravity, the theory of evolution, etc., are far different than what appears to be a very small dose-finding study for an antiemetic regimen in cancer patients conducted 30+ years ago.

This study may well have been a building block for future research in antiemetic regimens for nausea and vomiting in cancer patients at the time it was conducted and with the medications they had available at the time; however, in the 30+ years since this study was conducted much more research has been done and new medications have become available to ameliorate nausea and vomiting in cancer patients. One such medication is Zofran (ondansetron), which was approved in 1991.

In my original post I only discussed the main issues I had with the study, the most important of which was that there is no way to tell if a 50 mg dose of meto will or will not be more beneficial than other dose regimens discussed to date, because the results of the study are actually based on a total staggered dose of 150 mg meto (not 50 mg), with 100 mg administered hours after the chemotherapy - which, with SN would not be possible.

Some other potential issues I had with the study aside from those already described:

~The sample size was relatively small in the B arm of the study (25 patients), which would preclude drawing any definitive conclusions based on this study.

~Some may or may not have received prednisone in addition to meto, which may also aid in amelioration of nausea/vomiting so results of this study may have been confonded by concomitant prednisone use.

~They did not describe the patient population well enough -eg, what type and stage of cancer, age, concomitant medication use, BMI, etc.

~I am not sure how they measured nausea as this is a totally subjective experience and has the potential to bias the results based solely on this subjectivity.

~They did not describe the timing around how they measured the incidence of vomiting which would be a more objective measure of efficacy - for example, was it measured immediately during or after administration of chemotherapy, 24-hours post dose, 1-week post dose, etc.

~There were no specific lists of serious or severe adverse events in order to actually see what was reported by these patients. Tardive dyskinesia, a late-onset extrapyramidal reaction, is a potential severe side effect of meto use so it might be a good idea to see if there are increased reports of this adverse effect with an increased dose of meto. In cancer patients who have no other recourse to ameliorate nausea and vomiting, this may have been considered an acceptable risk at that time. A study conducted 3 years later concluded that: "the combination of dexamethasone and lorazepam can give major control of emesis in 25% of patients receiving very emetogenic chemotherapy. The addition of metoclopramide increases this to 67% on first exposure to chemotherapy, but at the expense of extrapyramidal reactions in 11.5%."
Br J Cancer. 1989 Nov; 60(5): 759–763. doi: 10.1038/bjc.1989.354. And please do not use this study as a valid source, as I have some of the same concerns with this study as with the one the OP posted.

~There were no reports of other concomitant medications that may have contributed to anti-nausea effects.

All in all, this study has many potentially confounding factors, which is why I wrote that "Personally, I" would be very careful extropolating information from this study.

Also, on edit, I do not think it is accurate to say it poses no adverse effects. Meto at regular doses is know to cause adverse effects when used for any indication. So it is very unlikely that there were no adverse effects.

 

[quiet.rabbit]

Interesting thread here:



Essentially, the vomiting effect of SN doesn't actually appear to make failure any more likely. I can certainly appreciate that not vomiting might make your experience more comfortable. Perhaps even it might make you less likely to call for help. But people don't fail as a result of vomiting soon after taking SN - or at least that hasn't been a thing from the case studies we have seen on here. So I'm questioning whether there is even much point having Meto.

I've never stated that you need Meto, only that it increases the chances of success since vomiting will get some SN out of you. Even if you ignore that, it's still not useless as it also serves as a prokinetic agent so more SN will be absorbed before you vomit. If you want to maximize the chances of success, it seems worth it since it's easy to obtain online.