Antiemetic Treatments

Share this content:
ANTIEMETIC TREATMENTS
ANTIEMETIC TREATMENTS
Generic Brand Form Strength Usual Dose
ANTICHOLINERGICS
scopolamine Transderm SCOP Rx trans-
dermal patch
1.5mg (delivers 1mg per 72hrs) Adults: Motion sickness: 1 patch 4hrs before travel; remove after 72hrs.
Post‑op: 1 patch evening before surgery.
C‑section: 1 patch 1hr before surgery. Remove 24hrs after surgery.
ANTIHISTAMINES
meclizine Antivert Rx tabs 12.5mg, 25mg, 50mg Adults: Motion sickness: 25−50mg 1hr before travel; then once daily as needed.
Vertigo: 25−100mg/day in divided doses.
Zentrip OTC orally-disinte-
grating thin strips
25mg Adults: 1 or 2 strips once daily 1hr before travel
diphen-
hydramine
Rx IV or IM inj 50mg/mL Adults: 10−50mg IV or deep IM; max 400mg/day
Children: 5mg/kg/day in 4 divided doses; max 300mg/day
CANNABINOIDS
dronabinol Marinol CIII caps 2.5mg, 5mg, 10mg Adults and Children: 5mg/m² 1−3hrs before chemo, then every 2−4hrs after chemo; max 4−6 doses/day
nabilone Cesamet CII caps 1mg Adults: 1−2mg twice daily; max 6mg/day in 3 divided doses. Start 1−3 hrs before chemo.
5-HT3 RECEPTOR ANTAGONISTS
dolasetron Anzemet Rx tabs 50mg, 100mg ≥16yrs: 100mg within 1hr before chemo or within 2hrs before surgery.
<16yrs: See drug monograph.
Rx IV inj 20mg/mL ≥16yrs: Prevention: 12.5mg 15mins before stopping anesthesia. Treatment: 12.5mg.
<16yrs: See drug monograph.
granisetron Rx tabs 1mg Adults: 2mg up to 1hr before chemo; or 1mg up to 1hr before, then 1mg 12hrs later. Radiation: 2mg within 1hr.
Rx IV inj 1mg/mL ≥2yrs: 10mcg/kg within 30mins before chemo
Sancuso Rx trans-
dermal patch
3.1mg/
 
day
≥18yrs: 1 patch 24−48hrs before chemo, remove at least 24hrs after completion; max 7 days
ondansetron Zofran Injection Rx IV or IM inj 2mg/mL >18yrs: 0.15mg/kg over 15min every 4hrs for 3 doses 30mins before chemo. Post‑op: 4mg before anesthesia or shortly post‑op.
<18yrs: See drug monograph.
Zofran Rx tabs 4mg, 8mg, 24mg Adults: Highly emetogenic: 24mg 30min before chemo. Moderately emetogenic: 8mg every 8hrs for 2 doses starting 30min before chemo, then 8mg every 12hrs for 1−2 days after. Post‑op: 16mg 1hr before anesthesia induction. TBI, single or daily fractionated radiotherapy to abdomen: See drug monographs.
Children: See drug monograph.
Rx ODT 4mg, 8mg
Rx soln 4mg/5mL
Zuplenz Rx oral soluble films 4mg, 8mg
palonosetron Aloxi Rx IV inj 0.075mg/
 
1.5mL
0.25mg/
 
5mL
≥17yrs: 30min before chemo give 0.25mg over 30sec; max 1 dose/wk. Post‑op: 0.075mg over 10sec before anesthesia induction.
PHENOTHIAZINES
chlorpro-
mazine
Rx tabs 10mg, 25mg, 50mg, 100mg, 200mg Adults: N/V: 10−25mg every 4−6hrs (tabs). 25−50mg every 3−4hrs (IM).
Children: See drug monograph.
Rx IV or IM inj 25mg/mL
prochlor-
perazine
Rx tabs 5mg, 10mg Adults: Oral: 5−10mg 3−4 times daily; max 40mg/day. Rectal: 25mg twice daily.
Children: See drug monograph.
Rx supps 25mg
promethazine Rx tabs 12.5mg, 25mg, 50mg Adults: Motion sickness: 25mg 30−60min before travel. Maintenance: 25mg twice daily. Perioperative N/V: 25mg; may give additional doses of 12.5−25mg every 4−6hrs.
Children: See drug monograph.
Rx supps 12.5mg, 25mg, 50mg
SUBSTITUTED BENZAMIDES
metoclo-
pramide
Metozolv ODT Rx ODT 5mg, 10mg Adults: Diabetic gastroparesis: 10mg 4 times daily 30min before meals and at bedtime for 2−8wks
Reglan Rx tabs 5mg, 10mg
trimetho-
benzamide
Tigan Rx caps 300mg Adults: 200mg (IM) or 300mg (oral) 3−4 times daily
Rx IM inj 100mg/
 
mL
SUBSTANCE P/NEUROKININ 1 RECEPTOR ANTAGONIST
aprepitant Emend Rx caps 40mg, 80mg, 125mg Adults: Chemotherapy induced: ≥12yrs: Give with corticosteroid and 5-HT3 antagonist 1hr before chemo. Day 1: 125mg. Days 2 and 3: 80mg; if no chemotherapy given, administer caps in the AM. PONV: ≥18yrs: 40mg within 3hrs prior to anesthesia.
Children: Chemotherapy induced: <12yrs: use oral susp. PONV: <18yrs: not established.
Emend Injection Rx IV inj 115mg/
 
vial
150mg/
 
vial
≥18yrs: Give with corticosteroid and 5-HT3 antagonist (see full labeling) 30mins before chemo. 150mg IV over 20–30mins on Day 1.
<18yrs: not established.
Emend Oral Suspension Rx susp 125mg <6mos or <6kg: not recommended. 6mos–<12yrs or patients unable to swallow: Give with corticosteroid and 5-HT3 antagonist (see full labeling) 1hr before chemo. Day 1: 3mg/kg (max 125mg). Days 2 and 3: 2mg/kg (max 80mg); if no chemotherapy given, administer susp in the AM.
rolapitant Varubi Rx tabs 90mg
≥18yrs: Give before each cycle, at no less than 2wk intervals. Highly emetogenic cisplatin-based chemotherapy: 180mg approx. 1–2hrs before chemo with dexamethasone 20mg PO/IV given 30mins before chemo on Day 1, then dexamethasone 8mg PO/IV twice daily on Days 2–4 and a 5-HT3 receptor ­antagonist on Day 1. Moderately emetogenic chemotherapy and combinations of anthracycline and cyclophosphamide: 180mg approx. 1–2 hrs before chemo with dexamethasone 20mg PO/IV given 30mins before chemo on Day 1 and a 5-HT3 receptor antagonist on Days 1– 4 (see full labeling).
<18yrs: not established.
NOTES

Key: TBI = total body irradiation; ODT = orally disintegrating tab

Patients' individual needs may vary. Adjust dose based on clinical effect.

Not an inclusive list of medications, official indications, and/or doses. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 1/2017)

You must be a registered member of Infectious Disease Advisor to post a comment.

Sign Up for Free e-newsletters