II. Indications
- Chemotherapy associated Nausea
- Radiation Therapy associated Nausea
III. Mechanism
- Blocks peripheral and central 5HT3 receptors
- Peripheral 5HT3 receptors at vagal nerve terminals
- Central 5HT3 receptors at ChemoreceptorTrigger Zone in Medulla (area postrema controls Vomiting)
IV. Dosing
-
Nausea with Chemotherapy (adult dosing unless otherwise specified)
- Intravenous (adults and children age >2 years)
- Give 10 mcg/kg IV over 5 minutes given 30 minutes before Chemotherapy
- SQ (Sustol)
- Give 10 mg SQ given 30 min prior to Chemotherapy
- Oral
- Take 2 mg orally once daily OR 1 mg orally twice daily given 1 hour before Chemotherapy
- Transdermal (Sancuso, 34 mg patch delivers 3.1 mg per 24 hours)
- Apply 1 patch to upper outer arm 24 to 48 hours before Chemotherapy
- Remove 24 hours after Chemotherapy (may use 1 patch continuously for up to 7 days)
- Avoid exposing patch to heat or sunlight
- Intravenous (adults and children age >2 years)
-
Nausea with Radiation Therapy (adult)
- Dose: 2 mg orally 1 hour before each Radiation Therapy treatment
V. Adverse Effects
VI. Safety
- Pregnancy Category B
- Unknown safety in Lactation
VII. Resources
VIII. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Aapro (2004) Oncologist 9(6):673-86 +PMID: 15561811
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