13
Moderate: Upper abdomen,
b
craniospinal irradiation
5-HT
3
receptor antagonist
c
Ondansetron 8 mg oral or 8 mg oral
dissolving tablet, or 8 mg
oral soluble film or 8 mg or
0.15 mg/kg IV
Use as prophylactic therapy.
Once daily to twice daily on
days of radiation therapy,
with first dose given before
radiation therapy.
d
Granisetron 2 mg oral or 1 mg or
0.01 mg/kg IV
Use as prophylactic therapy.
Once daily on days of
radiation therapy, before
radiation therapy.
d
Tropisetron 5 mg oral or IV Use as prophylactic therapy.
Once daily on days of
radiation therapy, before
radiation therapy.
d
Corticosteroid
Dexamethasone 4 mg oral or IV Use as prophylactic therapy.
Once daily on days of first 5
radiation therapy fractions,
before radiation therapy.
Low: Brain, head and neck, thorax, pelvis
e
5-HT
3
receptor antagonist
f
Ondansetron 8 mg oral or 8 mg oral
dissolving tablet, or 8 mg
oral soluble film or 8 mg or
0.15 mg/kg IV
Use as rescue therapy.
g
Granisetron 2 mg oral or 1 mg or
0.01 mg/kg IV
Use as rescue therapy.
g
Corticosteroid
Dexamethasone For brain, if not already
taking corticosteroid, 4
mg oral or IV; for other
anatomic regions, 4 mg
oral or IV
Use as rescue therapy. Titrate
up as needed to maximum of
16 mg oral or IV daily.
g
Dopamine receptor antagonist
h
Prochlorperazine 5–10 mg oral or IV Use as rescue therapy. Titrate
up as needed to maximum of
3–4 administrations daily.
g
Metoclopramide 5–20 mg oral or IV Use as rescue therapy. Titrate
up as needed to maximum of
3–4 administrations daily.
g
Table 5. Antiemetic Administration in Adults by Radiation
Therapy Risk Category (cont'd)