Prevention of nausea and vomiting associated with highly emetogenic chemotherapy, including cisplatin ≥50mg/m2. Prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy. Prevention of nausea and vomiting associated with radiotherapy in patients receiving total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen. Prevention of post-op nausea and vomiting.
See full labeling. Highly emetogenic chemotherapy: 24mg once 30 minutes before start of single-day chemotherapy (multi-day, single-dose not studied). Moderately emetogenic chemotherapy: 8mg every 8 hours for 2 doses beginning 30 minutes before chemotherapy, then 8mg every 12 hours for 1–2 days after chemotherapy completed. Total body irradiation: 8mg 1–2 hours before each fraction of radiotherapy administered each day. Single high-dose fraction radiotherapy to abdomen: 8mg 1–2 hours before radiotherapy, then 8mg every 8 hours after 1st dose for 1–2 days after radiation completed. Daily fractionated radiotherapy to abdomen: 8mg 1–2 hours before radiotherapy, then 8mg every 8 hours after 1st dose for each day of radiotherapy. Post-op prophylaxis: 16mg 1 hour before induction of anesthesia. For all: severe hepatic dysfunction: max 8mg/day.
Highly emetogenic chemotherapy, radiotherapy, or <4yrs of age: not recommended (see IV form). 4–11yrs: moderately emetogenic chemotherapy: 4mg every 4 hours for 3 doses beginning 30 minutes before chemotherapy, then 4mg every 8 hours for 1–2 days after chemotherapy completed. Post-op prophylaxis: see IV form.
Selective 5-HT3 receptor antagonist.
<4months of age (monitor closely). Congenital long QT syndrome: avoid. Electrolyte abnormalities, CHF, bradyarrhythmias, concomitant drugs that prolong QT: monitor ECG. May mask progressive ileus and/or gastric distention. Hepatic dysfunction. Pregnancy (Cat.B). Nursing mothers.
See Contraindications. Profound hypotension, loss of consciousness with apomorphine. May antagonize tramadol.
Diarrhea, headache, fever, constipation, abdominal pain, weakness, rash, transient blindness; rare: angina, bronchospasm, anaphylaxis, seizures, ECG changes (including QT prolongation).
Tabs 4mg, 8mg—30; ODT 4mg—30; ODT 8mg—10, 30; Oral soln—50mL; Single-dose vial (2mg/mL)—5 (2mL/vial); Multidose vial (2mg/mL)—1 (20mL/vial)