Novel Therapeutic Approach Using Proton Pump Inhibitor and Antiemetic Combination for Refractory Fever and Headache: A Case Series
Abstract
Delayed gastric emptying during acute illness may prevent adequate medication absorption, causing
therapeutic failure. We present three cases of refractory fever and headache that responded rapidly to proton
pump inhibitor and antiemetic combinations. A 60-year-old female with severe headache unresponsive to
paracetamol and mefenamic acid experienced complete relief 15 minutes after receiving pantoprazole 40mg
with domperidone 30mg. A six-year-old with fever persisting at 101°F despite ibuprofen achieved
defervescence within 20 minutes of lansoprazole 15mg with ondansetron 0.15mg/kg. A two-year-old with
febrile seizure and persistent fever at 102°F unresponsive to combination antipyretics normalized
temperature within 15 minutes of lansoprazole 15mg with ondansetron 0.15mg/kg. We hypothesize that
acute illness induces transient gastroparesis impairing drug absorption, and that PPI-antiemetic
combinations restore gastric function allowing absorption of previously administered but unabsorbed
medications. This warrants controlled investigation.
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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