11
Low
f
5-HT
3
receptor antagonist
Granisetron 2 mg oral or 1 mg or 0.01 mg/kg
IV or 1 transdermal patch or
10 mg subcutaneous
Ondansetron 8 mg oral twice daily or 8 mg
oral dissolving tablet twice daily
or 8 mg oral soluble film twice
daily or 8 mg or 0.15 mg/kg IV
Palonosetron 0.50 mg oral or 0.25 mg IV
Dolasetron 100 mg oral ONLY
Tropisetron 5 mg oral or 5 mg IV
Ramosetron 0.3 mg IV
Dexamethasone 8 mg oral or IV
NOTE: For patients who receive multiday 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 2 days thereaer. Patients can also be offered
the granisetron transdermal patch or granisetron extended-release injection that deliver therapy over
multiple days rather than taking a 5-HT
3
receptor antagonist daily.
a
If netupitant-palonosetron is used, no additional 5-HT
3
receptor antagonist is needed.
b
e dexamethasone dose is for patients who are receiving the recommended four-drug regimen
for highly emetic chemotherapy. If patients do not receive an NK
1
receptor antagonist, the
dexamethasone dose should be adjusted to 20 mg on day 1 and 16 mg on days 2–4.
c
In non-breast cancer populations (eg, non-Hodgkin lymphoma) receiving a combination of an
anthracycline and cyclophosphamide with treatment regimens incorporating corticosteroids, the
addition of palonosetron without the use of an NK
1
receptor antagonist and olanzapine is an
option.
d
If carboplatin area under the curve is ≥4 mg/mL/min, add an NK
1
receptor antagonist to the
5-HT
3
receptor antagonist and dexamethasone. Dexamethasone dosing is day 1 only: 20 mg with
rolapitant; 12 mg with aprepitant, fosaprepitant, or netupitant-palonosetron.
e
For moderate-emetic-risk agents with a known risk for delayed nausea and vomiting.
f
Patients treated with low-emetic-risk antineoplastic therapy should be offered a 5-HT
3
receptor
antagonist OR dexamethasone.
Table 3. Antiemetic Dosing for Adults by Chemotherapy
Risk Category (cont'd)
