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Emetogenic Potential of Antineoplastic Agents

September 16, 2009

Emetogenic Potential of Antineoplastic Agents (download)

EMETOGENIC POTENTIAL OF ANTINEOPLASTIC AGENTS
• AC combination: Doxorubicin (Adriamycin) or Epirubicin (Ellence) + Cyclophosphamide (Cytoxan, Neosar) • Altretamine (HMM, Hexalen) • Carmustine (BCNU, BiCNU) >250 mg/m² • Cisplatin (CDDP, Platinol, Platinol-AQ) ≥50 mg/m²	• Cyclophosphamide (CTX, Cytoxan, Neosar) >1,500 mg/m² • Dacarbazine (DTIC, DTIC-Dome) • Mechlorethamine (Mustargen) • Procarbazine (Matulane) oral • Streptozocin (Zanosar)
Moderate Risk (30–90% frequency without antiemetics)
• Aldesleukin (IL-2, Proleukin) >12–15 million units/m² • Amifostine (Ethyol) >300 mg/m² • Arsenic trioxide (A_s2O₃, Trisenox) • Azacitidine (Vidaza) • Busulfan (Busulfex) high dose >4 mg/d • Carboplatin (Paraplatin) • Carmustine (BCNU, BiCNU) ≤250 mg/m² • Cisplatin (CDDP, Platinol, Platinol-AQ) <50 mg/m² • Cyclophosphamide (CTX, Cytoxan, Neosar) ≤1,500 mg/m² • Cyclophosphamide (CTX) oral • Cytarabine (ARA-C, Cytosar-U) >1 g/m² • Dactinomycin (actinomycin D, Cosmegen) • Daunorubicin (Cerubidine, Daunomycin)	• Doxorubicin (Adriamycin) • Epirubicin (Ellence) • Etoposide (VP-16, VePesid) oral • Idarubicin (Idamycin) • Ifosfamide (Ifex) • Imatinib (Gleevec) oral* • Irinotecan (CPT-11, Camptosar) • Lomustine (CCNU, CeeNU) • Melphalan (L-PAM, Alkeran) >50 mg/m² IV • Methotrexate (MTX) 250 to >1,000 mg/m² • Oxaliplatin (Eloxatin) >75 mg/m² • Temozolomide (Temodar) oral • Vinorelbine (Navelbine) oral
Low Risk (10–30% frequency without antiemetics)
• Amifostine (Ethoyl) ≤300 mg • Bexarotene (Targretin) • Capecitabine (Xeloda) oral • Cetuximab (C225, Erbitux) • Cytarabine (ARA-C, Cytosar-U) ≤1 g/m² • Docetaxel (Taxotere) • Doxorubicin liposomal (Doxil) • Etoposide (VP-16, Etopophos, VePesid) IV • Fludarabine (Fludara) oral	• Fluorouracil (5-FU) • Gemcitabine (Gemzar) • Methotrexate (MTX) >50 mg/m² to <250 mg/m² • Mitomycin (MTC, Mitozytrex, Mutamycin) • Mitoxantrone (DHAD, Novantrone) • Paclitaxel (Taxol) • Paclitaxel albumin (Abraxane) • Pemetrexed (Alimta) • Topotecan (Hycamtin)
Minimal Risk (<10% frequency without antiemetics)
• Alemtuzumab (Campath) • Asparaginase (Elspar) • Bevacizumab (Avastin) • Bleomycin (Blenoxane) • Bortezomib (Velcade) • Busulfan (Busulfex) • Chlorambucil (Leukeran) oral • Cladribine (2-CdA, Leustatin) • Dasatinib (Sprycel) • Decitabine (Dacogen) • Denileukin diftitox (Ontak) • Dexrazoxane (Totect, Zinecard) • Erlotinib (Tarceva) • Fludarabine (Fludara) IV • Gefitinib (Iressa) • Gemtuzumab ozogamicin (Mylotarg)	• Hydroxyurea (Hydrea) oral • Interferon alpha (IFN-alpha, Intron A) • Lenalidomide (Revlimid) • Melphalan (L-PAM, Alkeran) low dose oral • Methotrexate (MTX) ≤50 mg/m² • Nelarabine (Arranon) • Pentostatin (Nipent) • Rituximab (Rituxan) • Sorafenib (Nexavar) • Sunitinib (Sutent) • Thalidomide (Thalomid) • Thioguanine (6-TG,Tabloid) oral • Trastuzumab (Herceptin) • Vinblastine (VLB) • Vincristine (VCR) • Vinorelbine (Navelbine) IV
NOTES
* Daily use of antiemetics is not recommended based on clinical experience. Adapted from: 1. Kris MG, Hesketh PJ, Somerfield MR, et al. American Society of Clinical Oncology Guideline for Antiemetics in Oncology: Update 2006. J Clin Oncol 2006;24:2932-2947. 2. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology; v.1.2007: Antiemesis. Available at: http://www.nccn.org/professionals/physician_gls/PDF/antiemesis.pdf. Accessed October 18, 2007. (Rev. 4/2008)

EMETOGENIC POTENTIAL OF ANTINEOPLASTIC AGENTS

High Risk (>90% frequency without antiemetics)

• AC combination: Doxorubicin (Adriamycin) or Epirubicin
(Ellence) + Cyclophosphamide (Cytoxan, Neosar)

• Altretamine (HMM, Hexalen)

• Carmustine (BCNU, BiCNU) >250 mg/m²

• Cisplatin (CDDP, Platinol, Platinol-AQ) ≥50 mg/m²

• Cyclophosphamide (CTX, Cytoxan, Neosar) >1,500 mg/m²

• Dacarbazine (DTIC, DTIC-Dome)

• Mechlorethamine (Mustargen)

• Procarbazine (Matulane) oral

• Streptozocin (Zanosar)

Moderate Risk (30–90% frequency without antiemetics)

• Aldesleukin (IL-2, Proleukin) >12–15 million units/m²

• Amifostine (Ethyol) >300 mg/m²

• Arsenic trioxide (A_s2O₃, Trisenox)

• Azacitidine (Vidaza)

• Busulfan (Busulfex) high dose >4 mg/d

• Carboplatin (Paraplatin)

• Carmustine (BCNU, BiCNU) ≤250 mg/m²

• Cisplatin (CDDP, Platinol, Platinol-AQ) <50 mg/m²

• Cyclophosphamide (CTX, Cytoxan, Neosar) ≤1,500 mg/m²

• Cyclophosphamide (CTX) oral

• Cytarabine (ARA-C, Cytosar-U) >1 g/m²

• Dactinomycin (actinomycin D, Cosmegen)

• Daunorubicin (Cerubidine, Daunomycin)

• Doxorubicin (Adriamycin)

• Epirubicin (Ellence)

• Etoposide (VP-16, VePesid) oral

• Idarubicin (Idamycin)

• Ifosfamide (Ifex)

• Imatinib (Gleevec) oral*

• Irinotecan (CPT-11, Camptosar)

• Lomustine (CCNU, CeeNU)

• Melphalan (L-PAM, Alkeran) >50 mg/m² IV

• Methotrexate (MTX) 250 to >1,000 mg/m²

• Oxaliplatin (Eloxatin) >75 mg/m²

• Temozolomide (Temodar) oral

• Vinorelbine (Navelbine) oral

Low Risk (10–30% frequency without antiemetics)

• Amifostine (Ethoyl) ≤300 mg

• Bexarotene (Targretin)

• Capecitabine (Xeloda) oral

• Cetuximab (C225, Erbitux)

• Cytarabine (ARA-C, Cytosar-U) ≤1 g/m²

• Docetaxel (Taxotere)

• Doxorubicin liposomal (Doxil)

• Etoposide (VP-16, Etopophos, VePesid) IV

• Fludarabine (Fludara) oral

• Fluorouracil (5-FU)

• Gemcitabine (Gemzar)

• Methotrexate (MTX) >50 mg/m² to <250 mg/m²

• Mitomycin (MTC, Mitozytrex, Mutamycin)

• Mitoxantrone (DHAD, Novantrone)

• Paclitaxel (Taxol)

• Paclitaxel albumin (Abraxane)

• Pemetrexed (Alimta)

• Topotecan (Hycamtin)

Minimal Risk (<10% frequency without antiemetics)

• Alemtuzumab (Campath)

• Asparaginase (Elspar)

• Bevacizumab (Avastin)

• Bleomycin (Blenoxane)

• Bortezomib (Velcade)

• Busulfan (Busulfex)

• Chlorambucil (Leukeran) oral

• Cladribine (2-CdA, Leustatin)

• Dasatinib (Sprycel)

• Decitabine (Dacogen)

• Denileukin diftitox (Ontak)

• Dexrazoxane (Totect, Zinecard)

• Erlotinib (Tarceva)

• Fludarabine (Fludara) IV

• Gefitinib (Iressa)

• Gemtuzumab ozogamicin (Mylotarg)

• Hydroxyurea (Hydrea) oral

• Interferon alpha (IFN-alpha, Intron A)

• Lenalidomide (Revlimid)

• Melphalan (L-PAM, Alkeran) low dose oral

• Methotrexate (MTX) ≤50 mg/m²

• Nelarabine (Arranon)

• Pentostatin (Nipent)

• Rituximab (Rituxan)

• Sorafenib (Nexavar)

• Sunitinib (Sutent)

• Thalidomide (Thalomid)

• Thioguanine (6-TG,Tabloid) oral

• Trastuzumab (Herceptin)

• Vinblastine (VLB)

• Vincristine (VCR)

• Vinorelbine (Navelbine) IV

NOTES

* Daily use of antiemetics is not recommended based on clinical experience.

Adapted from:

1. Kris MG, Hesketh PJ, Somerfield MR, et al. American Society of Clinical Oncology Guideline for Antiemetics in Oncology: Update 2006. J Clin Oncol 2006;24:2932-2947.

2. National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology; v.1.2007: Antiemesis.

Available at: http://www.nccn.org/professionals/physician_gls/PDF/antiemesis.pdf. Accessed October 18, 2007.

(Rev. 4/2008)

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Diltiazem HCl 120mg, 180mg, 240mg; ext-rel caps.

LEVSIN

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MYLANTA GAS

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TABLOID

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ASTELIN

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B-NEXA

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