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Serotonin Receptor Antagonists
Dopamine Receptor Antagonists
Corticosteriods
Other Agents

Serotonin Receptor Antagonists:
Dolasetron (Anzemet) 100 mg PO X 1 or 100 mg (1.8 mg/kg) IV
Granisetron (Kytril) 1 mg PO X 1 or 1 mg (0.01 mg/kg) IV
Ondansetron (Zofran) 16-24 mg PO X 1 or 8 mg po BID or 8 mg (0.15 mg/Kg) IV
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Corticosteroids:
Dexamethasone 20 mg po/IV X1

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Other Agents:
Droperidol (Inapsine) 1.25-2.5 mg IV or 2.5-10 mg IM
Metoclopramide (Reglan) 2-3 mg/kg Q 2hours IV/PO
Haloperidol 1-2 mg PO/IV Q 4-6 hours
Dronabinol 5 mg/m2 Q 4hours PO
Prochlorperzine (Compazine) 10-20 mg IV Q2-3 hours
Promethazine (Phenergan) 12.5-25 mg PO/IM/PR Q4-6 hours
Olanzapine (Zyrpexa) 10-15 mg po QD
Lorazepam 0.5-2.0 mg PO/SL/IV

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DELAYED EMESIS REGIMEN:
In all patients receiving CISPLATIN, a corticosteroid + metoclopramide or a 5-HT3 antagonist is recommended for the prevention of delayed emesis.

Among patients receiving CYCLOPHOSPHAMIDE, ANTHRACYCLINES, CARBOPLATIN, or combinations of these agents, the incidence of delayed emesis varied from 20% to 30% in patients not given prophylactic antiemetics for delayed emesis. Use of a corticosteroid as part of the acute emesis regimen was associated with a lower incidence of delayed emesis. A delayed emesis regimen may be given with this degree of risk, but data are lacking concerning efficacy & specific regimen choices.
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Emetic Potential:
--VERY HIGH--
Cisplatin
-----HIGH-----
Carboplatin
Carmustine
Cyclophosphamide
Cytarabine
Dacarbazine
Doxorubicin
Epirubicin
Hexamethylmelamine
Idarubicin
Ifosfamide
Mechlorethamine
Mitoxantrone
Procarbazine
Streptozocin
--INTERMEDIATE--
Docetaxel
Etoposide
Fluorouracil
Irinotecan
Gemcitibine
Methotrexate (>50 mg/m2)
Mitomycin
Paclitaxel
----LOW----
Belomycin
Busulfan
Chlorambucil
Fludarabine
Hydroxyurea
Methotrexate (<50 mg/m2)
Melphalan
Thioguanine
Vinblastine
Vincristine
Vinorelbine