Recommended Dose-Schedule Tables
Table 1. Antiemetic Dosing by Chemotherapy Risk Category Day of Chemotherapy Subsequent Days
High Emetic Riska NK1
Antagonist 5-HT3 Aprepitant Fosaprepitant Antagonist Granisetron Ondansetron Palonosetron
Dolasetron Tropisetron
Ramosetron Corticosteroidb
Moderate Emetic Riskc 5-HT3
Corticosteroid
Low Emetic Risk Corticosteroid
125 mg oral 150 mg IV
2 mg oral; 1 mg or 0.01 mg/kg IV
8 mg oral twice daily; 8 mg or 0.15 mg/kg IV
0.50 mg oral; 0.25 mg IV
100 mg oral ONLY
5 mg oral; 5 mg IV
0.3 mg IV
Dexamethasone 12 mg oral; 12 mg IV
Antagonist Palonosetrond
0.50 mg oral; 0.25 mg IV
Dexamethasone 8 mg oral; 8 mg IV
Dexamethasone 8 mg oral; 8 mg IV
Note: For patients receiving multi-day chemotherapy, clinicians must first determine the emetic risk of the agent(s) included in the regimen. Patients should receive the agent of the highest therapeutic index daily during chemotherapy and for two days thereaſter. Patients can also be offered the granisetron
transdermal patch that delivers therapy over multiple days rather than taking a serotonin antagonist daily. a Includes AC (combination of anthracycline and cyclophosphamide). b The dexamethasone dose is for patients who are receiving the recommended three-drug regimen for
highly emetic chemotherapy. If patients do not receive aprepitant, the dexamethasone dose should be adjusted to 20 mg on day one and 16 mg on days 2-4. c Clinicians who choose to utilize an NK1
Importantly, corticosteroid is given only on day one; dexamethasone dose is 12 mg. d Granisetron and ondansetron are the preferred substitutions if palonosetron is not available.
antagonist should follow high emetic risk chemotherapy dosing. 8 mg; days 2 & 3
8 mg oral or IV; days 2-3 or days 2-4
80 mg oral; days 2 & 3
