A Case Report on Effect of Asenapine Sublingual Tablets on Intractable Nausea in a Patient of Terminal Malignant Lymphoma with Diabetes Who Cannot Take Oral Medicine

Hiroyuki Watanabe; Kazuyuki Nakamura; Ayumi Ishikawa; Jinwoo Lee; Yasunori Adachi; Toshitaka Nabeshima; Yoji Sugiura

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A Case Report on Effect of Asenapine Sublingual Tablets on Intractable Nausea in a Patient of Terminal Malignant Lymphoma with Diabetes Who Cannot Take Oral Medicine

VernacularTitle:糖尿病を合併した終末期悪性リンパ腫患者の経口投与が困難な難治性悪心に対してアセナピン舌下錠が著効した1例
Author: Hiroyuki WATANABE ¹ ; Kazuyuki NAKAMURA ¹ ; Ayumi ISHIKAWA ¹ ; Jinwoo LEE ² ; Yasunori ADACHI ² ; Toshitaka NABESHIMA ³ ; Yoji SUGIURA ⁴
Author Information

1. Department of Pharmacy, Anjo Kosei Hospital
2. Department of Palliative Medicine, Anjo Kosei Hospital
3. Japanese Drug Organization of Appropriate Use and Research
4. Advanced Diagnostic System Research Laboratory, Fujita Health University Graduate School of Health Sciences
Keywords: asenapine; multi-acting receptor targeted antipsychotic; intractable nausea; sublingual tablet
From:Palliative Care Research 2021;16(2):133-138
CountryJapan
Language:Japanese
Abstract: Introduction: We report a case of intractable nausea of a terminal malignant lymphoma patient with diabetes, which improved by sublingual administration of asenapine. Case: A 78-year-old man suffering from diffuse large B-cell lymphoma with diabetes presented intractable nausea and vomiting. Those symptoms were thought to be due to masses and nodules in the right frontal lobe and the cerebellum, and/or due to edema in the peripheral brain parenchyma. Because it was difficult to take medicines orally, we selected injections to control those symptoms. However, the combination of metoclopramide, haloperidol, and hydroxyzine injections failed to relieve nausea. Olanzapine is effective against nausea but is contraindicated for diabetic patients, so asenapine, one of the multi-acting receptor-targeted antipsychotics the same as olanzapine, was expected alternatively. The patient was administrated asenapine sublingually 5mg once a day before bedtime. This administration of asenapine remarkably improved his nausea. Discussion: Sublingual asenapine dose may be an effective therapeutic option for intractable nausea.