ANTIEMETICS
Generic & Class Brand & Company Form(s) Strength(s)   Usual Dose*
ANTICHOLINERICS
Scopolamine Transderm SCOP
Novartis Cons.		 transdermal patch 1.5mg (delivers 1mg per 72hrs) Rx Motion sickness: 1 patch 4hrs before departure, remove after 72hrs.
Post-op: 1 patch evening before surgery.
C-section: 1 patch 1hr before surgery. Remove 24 hrs after surgery.
ANTIHISTAMINES
Meclizine Antivert
Pfizer		 tabs 12.5mg, 25mg, 50mg Rx Motion sickness: 25–50mg 1hr before departure, then once daily.
Vertigo: 25–100mg/day in divided doses.
Zentrip
Sato		 orally-disintegrating thin strips 25mg OTC Dissolve on tongue. 1 or 2 strips once daily, start 1 hour prior to travel.
Diphenhydramine Benadryl
Pfizer		 IV or IM inj 50mg/mL Rx Adults: 10–50mg IV or deep IM; max 400mg.
Children: 5mg/kg/day in 4 divided doses; max 300mg/day.
CANNABINOIDS
Dronabinol Marinol
Unimed		 caps 2.5mg, 5mg, 10mg CIII Initially 5mg/m2 1–3hrs before chemo, then every 2–4hrs; max 4–6 doses and 15mg/m2/day.

 
Nabilone Cesamet
Valeant		 caps 1mg CII 1–2mg twice daily; max 6mg/day in 3 divided doses. Start 1–3 hrs before chemo.
5-HT3 RECEPTOR ANTAGONISTS
Dolasetron Anzemet
Sanofi-Aventis		 tabs 50mg, 100mg Rx Adults: 100mg within 1hr before chemo or within 2hrs before surgery.
Children: <2 yrs: not recommended. 2–16 yrs: 1.8mg/kg within 1hr before chemotherapy; or, 1.2mg/kg within 2hrs before surgery. Max 100mg/dose.
IV inj 20mg/mL Rx Adults: ≥16yrs: 1.8mg/kg about 30mins before chemo; or, may give 100mg IV. Prevention: 12.5mg about 15 minutes before stopping anesthesia. Treatment: 12.5mg as needed.
Children: <2 yrs: not recommended. 2–16 yrs: Prevention: 0.35mg/kg IV (max 12.5mg) about 15mins before stopping anesthesia; or, 1.2mg/kg (max 100mg) diluted in apple or apple-grape juice and taken orally within 2hrs before surgery. Treatment: 0.35mg/kg IV as soon as needed.
Granisetron Kytril
Roche		 tabs 1mg Rx 2mg up to 1hr before chemo; or 1mg up to 1hr before, then 1mg 12hrs after 1st dose.
Radiation: 2mg within 1hr.
IV inj 1mg/mL Rx ≥2yrs: 10micrograms/kg within 30mins before chemo.
Sancuso
ProStrakan		 transdermal patch 3.1mg/day Rx 1 patch 24–48hrs before chemo, remove at minimum 24hrs after completion of chemo; max 7 days.
Ondansetron Zofran
GSK		 tabs 4mg, 8mg, 24mg Rx Highly emetogenic: 24mg 30mins before chemo.
Moderately emetogenic: 8mg for 2 doses starting 30mins before chemo, then 8mg every 12hrs for 1–2 days after.
Post-op prophylaxis: 16mg 1hr before anesthesia.
orally-disintegrating tabs (ODT) 4mg, 8mg Rx
soln 4mg/5mL Rx
IV or IM inj 2mg/mL Rx >18yrs: 32mg once or 0.15mg/kg every 4hrs for 3 doses 30mins before chemo.
Post-op: 4mg IV before anesthesia or shortly post-op.
Zuplenz
Strativa		 Oral soluble films 4mg, 8mg Rx Adults: Highly emetogenic: 24mg (given successively as three 8mg films) 30mins before chemo.
Moderate emetogenic: 8mg every 8hrs for 2 doses starting 30mins before chemo, then 8mg every 12hrs for 1–2 days after.
TBI, single high-dose fraction or daily fractionated radiotherapy: see monograph.
Post-op prophylaxis: 16mg (given successively as two 8mg films) 1hr before anesthesia.
Children: Highly emetogenic chemotherapy, radiotherapy, post-op prophylaxis or <4yrs of age: not recommended. 4–11yrs: Moderately emetogenic: 4mg every 4hrs for 3 doses starting 30mins before chemo, then 4mg every 8hrs for 1–2 days after.
Palonosetron Aloxi
Eisai		 IV inj 0.075mg/1.5mL
0.25mg/5mL		 Rx Chemotherapy: ≥18yrs: give 30 minutes prior to chemotherapy. 0.25mg IV over 30 seconds; max 1 dose/week.
Post-op: give immediately before anesthesia induction. 0.075mg IV over 10 seconds.
PHENOTHIAZINES
Chlorpromazine (various) tabs 10mg, 5mg, 50mg, 100mg, 200mg Rx 10–25mg every 4–6hrs.
inj 25mg/mL Rx 25–50mg every 3–4hrs.
Prochlorperazine (various) tabs 5mg, 10mg Rx 5–10mg 3–4 times daily; max 40mg/day.
supps 2.5mg, 5mg, 25mg Rx 25mg twice daily; max 40mg/day.
Promethazine (various) tabs 12.5mg, 25mg, 50mg Rx Motion sickness: 25mg 30–60mins before departure, maintenance: 25mg every 12hrs.
Peri-op: initially 25mg, then 12.5–25mg every 4–6hrs.
supps 12.5mg, 25mg, 50mg Rx
SUBSTITUTED BENZAMIDES
Metoclopramide Metozolv ODT
Salix		 orally-disintegrating tabs 5mg, 10mg Rx Diabetic gastroparesis: 10mg 4 times daily 30 minutes before meals and at bedtime for 2–8 weeks. Allow tablet to dissolve on tongue. Renal impairment: reduce dose.
Reglan
UCB		 tabs 5mg, 10mg Rx N/V dues to diabetic gastroparesis: 10mg 30mins before meals and bedtime for 2–8 weeks.
Trimethobenzamide Tigan
King		 caps 300mg Rx 200mg (IM) or 300mg (oral) 3–4 times daily.
IM inj 100mg/mL Rx
SUBSTANCE P/NEUROKININ 1 RECEPTOR ANTAGONIST
Aprepitant Emend
Merck		 caps 40mg, 80mg, 125mg Rx Chemo-induced: 125mg 1hr before chemo; then on days 2 and 3: 80mg in AM.
Post-op prophylaxis: 40mg within 3hrs prior to anesthesia
Emend Injection
Merck		 IV inj 115mg/vial
150mg/vial		 Rx ≥18yrs: Give with corticosteroid and 5-HT3 antagonist, approx. 30min prior to chemo.
Highly emetogenic (Single dose regimen): 150mg IV over 20–30min on Day 1. Moderately or highly emetogenic: 3-Day regimen: 115mg IV over 15min on Day 1, then Days 2 and 3: 80mg orally once daily in the AM.
NOTES

*Usual Dose is the manufacturer's suggested dose for healthy adults (eg, doses for hepatic or renal impairment are not shown). Patients' individual needs may vary. Adjust dose based on clinical effect.

• TBI = total body irradiation

• See individual product entries for exact indications, other dosing information, IV infusion rates, and other important information.

(Rev. 5/2011)