Anti-Emetics:

Aprepitant (Emend®)

Substance P/Neurokinin 1 Receptor antagonist.

Dosage: (Prevention of acute and delayed nausea and vomiting associated with highly-emetogenic chemotherapy in combination with a corticosteroid and 5-HT3 receptor antagonist): 125 mg orally on day 1, followed by 80 mg on days 2 and 3; should be used in combination with a corticosteroid (e.g. Dexamethasone: 12 mg po on day 1, followed 8 mg on days 2, 3, and 4) and 5-HT3 receptor antagonist (e.g. Ondansetron: 32 mg IV on day 1).

Supplied: 80 mg, 125 mg capsule

dolasetron (Anzemet ®):

Nausea (chemotherapy): 1.8 mg/kg up to 100mg IV/orally x 1.
Post-op: 12.5 mg IV x 1.
Prevention: 100mg orally 2 hours preop.

droperidol (Inapsine ®):

Nausea - usual dose: 1.25 to 2.5 mg IV or IM

granisetron (Kytril ®):

Selective 5-HT3 Receptor Antagonist
Nausea (chemotherapy): 
IV: 10 mcg/kg IV over 5 minutes one-half hour prior to chemo.
Oral: 1 mg orally twice daily x 1 day only.

metoclopramide (Reglan ®):

Nausea: 10 mg IV/IM every 2-3 hours as needed.
Oral: 10-15 mg orally four times daily, 30 minutes before meals and at bedtime.

ondansetron  (Zofran ®):

Selective 5-HT3 Receptor Antagonist.
Prevention of chemotherapy-induced emesis: 0.15 mg/kg IV 3 times/day beginning 30 minutes prior to chemotherapy or 0.45 mg/kg IV once daily or 8-10 mg IV 1-2 times/day or 24 mg or 32 mg once daily.

Oral: Highly-emetogenic agents/single-day therapy: 24 mg orally given 30 minutes prior to the start of therapy. Moderately-emetogenic agents: 8 mg orally q12h beginning 30 minutes before chemotherapy, continuously for 1-2 days after chemotherapy completed. Total body irradiation: 8 mg po 1-2 hours before each daily fraction of radiotherapy

Post-op nausea: 4 mg IV (over 2-5 minutes) or IM x 1 immediately before induction of anesthesia OR 16 mg orally 1 hour before anesthesia.
Note: Repeat doses given in response to inadequate control of nausea/vomiting from preoperative doses are generally ineffective.

Treatment of hyperemesis gravidum (unlabeled use):
Oral: 8 mg q12h. IV: 8 mg administered over 15 minutes q12h or 1 mg/hour infused continuously for up to 24 hours.

Supplied:
Infusion [premixed in D5W] (Zofran®): 32 mg (50 mL).
Injection solution (Zofran®): 2 mg/mL (2 mL, 20 mL).
Oral Soln (Zofran®): 4 mg/5 mL (50 mL) .
Tablet (Zofran®): 4 mg, 8 mg, 24 mg
Tablet, orally-disintegrating (Zofran® ODT): 4 mg, 8 mg.

prochlorperazine (Compazine ®):

IV: 2.5 to 10mg IV over at least 2 minutes (< 5 mg/min). Do not exceed 10 mg/dose or 40mg/day. May repeat usual dose q3-4h as needed.
Oral / IM: 5-10mg orally or deep IM 3 to 4 times daily. (Max 40mg/day).
Rectally: 25 mg rectally every 12 hours.

scopolamine:

Motion sickness: apply 1 disc behind ear 4 hours prior to event. Replace every 3 days.

trimethobenzamide (Tigan ®):

Oral: 250 mg orally every 6 to 8 hours
IM / Rectal: 200mg IM or rectally every 6 to 8 hours.
 

Disclaimer
Listed dosages are for - Adult patients ONLY. PLEASE READ THE DISCLAIMER CAREFULLY BEFORE ACCESSING OR USING THIS SITE. BY ACCESSING OR USING THIS SITE, YOU AGREE TO BE BOUND BY THE TERMS AND CONDITIONS SET FORTH IN THE DISCLAIMER. GlobalRPH does not directly or indirectly practice medicine or provide medical services and therefore assumes no liability whatsoever of any kind for the information and data accessed through the Service or for any diagnosis or treatment made in reliance thereon.

David F. McAuley, Pharm.D., R.Ph.  GlobalRPh Inc.

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