CURRENT Diagnosis &Treatment: Family Medicine, 5e >Hospice &Palliative Medicine

Jeannette E. South-Paul, Samuel C. Matheny, Evelyn L. Lewis+

Table 67–4.Commonly used antiemetics.

Drug Receptor Activity/Effect Common Indication Dosage/Route Side Effects

0.5–4 mg PO or SC or IV every 6
Haloperidol D2 Opioid-induced N/V EPS, QTc prolongation
hours (Q6h)

Opioid-induced N/V, delayed gastric 5–20 mg PO or SC or IV before meals EPS, esophageal spasm, colic in
Metoclopramide Peripheral D2
emptying and at bedtime complete bowel obstruction

Opioid-induced N/V, N/V of unknown 5–10 mg PO or IV Q6h or 25 mg PR

Prochlorperazine D2 EPS and sedation
etiology Q6h

Dry mouth, blurred vision, ileus,

1.5 mg transdermal patch every 3
Scopolamine Ach, H1 Vestibular dysfunction urinary retention, and confusion; patch
days
starts being effective after 24 hours

Chemotherapy- or radiation 4–8 mg PO as pill or dissolvable tablet

Ondansetron 5-HT3 Headache, fatigue, constipation
therapy–induced N/V or IV every 4–8 hours

Increased intracranial pressure, 4–8 mg every morning or BID, PO (pill

Dexamethasone Decreases intracranial pressure Agitation, insomnia, hyperglycemia
capsular stretch or liquid) or IV

Lorazepam GABA receptor Anticipatory N/V 0.5–2 mg PO or IV every 4–6 hours Sedation, confusion, delirium

125 mg PO on day 1, 80 mg PO on Somnolence, fatigue, may reduce

Aprepitant NK1 Severe chemotherapy-induced N/V
days 2–3 warfarin levels

BID, twice per day; EPS, extrapyramidal symptoms; GABA, γ-aminobutyric acid; IV, intravenous; N/V, nausea/vomiting; PO, per mouth; PR, per rectum; SC, subcutaneous.

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