For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .
Predictive Factors of Delayed Emesis in Cisplatin‐Treated Patients and Antiemetic Activity and Tolerability of Metoclopramide or Dexamethasone: A Randomized Single‐Blind Study
To prevent delayed emesis induced by cisplatin ( mean dose 90 mg/m2 ) , 120 consecutive patients were r and omized to receive , in a 7-day crossover design , oral metoclopramide ( 20 mg q.i.d . ) , dexamethasone ( 1 mg q.i.d . ) or placebo ( two tablets q.i.d . ) starting 24 hours after the end of chemotherapy .  Complete protection from nausea , but not from vomiting . was significantly increased by both dexamethasone and metoclopramide with respect to placebo . Important prognostic factors favoring the appearance of delayed emesis were incomplete protection from vomiting during the first 24 hours after cisplatin , female gender , and highest cisplatin doses . Tolerability of both drugs was good . Larger and r and omized controlled trials are necessary to identify better preventive treatment of delayed emesis induced by cisplatin
For persons receiving chemotherapy of high emetic risk , there is no group of patients for whom agents of lower therapeutic index are appropriate first-choice antiemetics .
In all patients receiving cisplatin and all other agents of high emetic risk , the two-drug combination of dexamethasone and aprepitant is recommended for the prevention of delayed emesis .
The Up date Committee no longer recommends the combination of a 5-HT3 serotonin receptor antagonist and dexamethasone for the prevention of delayed emesis after chemotherapeutic agents of high emetic risk .
PURPOSE To up date the 1999 American Society of Clinical Oncology guideline for antiemetics in oncology .