Antacids (also see Chapter 20 Medication Tables)
Magnesium hydroxide (mag NEE zhum) (hye DROX ide)
Various products
Oral
Liquid
5–15 mL up to 4 times/day as needed
OTC
Aluminum hydroxide (a LOO mi num) (hye DROX ide)
Various products
Oral
Liquid
10 mL 5–6 times daily after meals and at bedtime as needed
OTC
Calcium carbonate (KAL see um) (KAR bon ate)
Various products
Oral
Tablet, liquid
1–4 tablets as symptoms occur; 10–15 mL q 2–4 hr as needed
OTC
H2-Receptor Antagonists (also see Chapter 20 Medication Tables)
Cimetidine (sye MET i deen)
Tagamet HB
Oral
Tablet, liquid
200 mg up to twice daily as needed
OTC
Famotidine (fa MOE ti deen)
Pepcid AC
Oral
Tablet, liquid
10–20 mg up to twice daily as needed taken 10–60 min before meals
OTC
Nizatidine (ni ZA ti deen)
Axid AR
Oral
Tablet, solution
150 mg up to twice daily as needed
OTC
Proton Pump Inhibitors (also see Chapter 20 Medication Tables)
Dexlansoprazole (dex lan SOE pra zole)
Dexilant
Oral
Tablet
30 mg once daily
Rx
Esomeprazole (es oh ME pray zol)
Nexium
Oral
Tablet
20 mg once daily as needed
OTC
Lansoprazole (lan SOE pra zole)
Prevacid
Oral
Tablet
15 or 30 mg once daily as needed
OTC
Omeprazole (oh ME pray zol)
Prilosec
Oral
Tablet
20 mg once daily as needed
OTC
Pantoprazole (pan TOE pra zole)
Protonix
Oral
Tablet
20–40 mg once daily as needed
Rx
Rabeprazole (ra BE pray zole)
AcipHex
Oral
Tablet
20 mg once daily as needed
Rx
Anticholinergics
Scopolamine (skoe POL a meen)
Transderm Scop
Transdermal
Patch
1 mg q 72 hr as needed
Rx
Antihistamines
Dimenhydrinate (dye men HYE dri nate)
Dramamine
Oral, IV, IM
Tablet, injection
Oral: 50–100 mg q 4–6 hr as needed; IM, IV: 50 mg q 4 hrs
OTC
Diphenhydramine (dye fen HYE dra meen)
Benadryl
Oral, IV, IM
Tablet, capsule, liquid, injection
Oral: 25 mg q 4–6 hr or 50 mg q 6–8 hr as needed; IM, IV: 10–50 mg q 6 hr as needed
OTC
Hydroxyzine (hye DROX i zeen)
Vistaril
Oral
Tablet, liquid
25–50 mg q 6 hr as needed
Rx
Meclizine (MEK li zeen)
Bonine, Antivert, Dramamine Less Drowsy
Oral
Tablet
25–50 mg 1 hr before travel or 25–100 mg daily in divided doses
OTC
Phenothiazines
Chlorpromazine (klor PROE ma zeen)
Thorazine
Oral, IV, IM
Tablet, injection
Oral: 10–25 mg q 4–8 hr as needed; IM, IV: 10–25 mg q 3–4 hr as needed
Rx
Prochlorperazine (proe klor PER a zeen)
Compazine, Compro
Oral, rectal, IV, IM
Tablet, suppository, injection
Oral: 5–10 mg 3–4 times daily as needed; rectal: 25 mg twice daily as needed; IM: 5–10 mg q 3–4 hr as needed; IV: 2.5–10 mg q 3–4 hr as needed
Rx
Promethazine (proe METH a zeen)
Phenergan
Oral, rectal, transdermal, IV, IM
Tablet, liquid, suppository, injection
12.5–25 mg q 4–6 hr as needed
Rx
Butyrophenones
Droperidol (droe PER i dole)
Inapsine
IV, IM
Injection
0.625–1.5 mg after surgery
Rx
Haloperidol (ha loe PER i dole)
Haldol
Oral, IM, IV
Tablet, injection
0.5–1 mg q 6 hrs as needed for CINV; 0.5–2 mg as a single dose at end of surgery for PONV
Rx
Benzamides
Metoclopramide (met oh KLOE pra mide)
Reglan
Oral, IM, IV
Tablet, liquid, injection
N/V: IV or oral; IV, 10 or 20 mg as a single dose; oral, 10 mg as a single dose and may repeat after 4–6 hr if needed
CINV: oral 10 mg before chemotherapy or 10 mg q 6 hr as needed; can also be used 10–20 mg four times/day on post-chemotherapy days 2–4 and can be given in combination with dexamethasone; delayed CINV: 0.5 mg/kg or 20 mg q 6 hr as needed, 2–4 days
Rx
Trimethobenzamide (trye meth oh BEN za mide)
Tigan
Oral, IM
Capsule, injection
Oral: 300 mg 3–4 times daily; IM: 200 mg 3–4 times daily
Rx
Corticosteroids
Dexamethasone (dex a METH a sone)
Decadron
Oral, IM, IV
Tablet, injection
Can be given with NK1-receptor antagonist and serotonin-receptor antagonist with or without olanzapine; 10 mg prior to chemotherapy; 12 or 20 mg oral or IV, depending on specific NK1 antagonist used; on post-chemotherapy days, can be given 8 mg once or twice daily on days 2–4, depending on which agents dexamethasone was administered with
Rx
Cannabinoids
Dronabinol (droe NAB i nol)
Marinol, Syndros
Oral
Capsule
Capsule: 5 mg/m2 before chemotherapy, then q 2–4 hr as needed for a total of 4–6 doses/day; increase dose in increments of 2.1 mg/m2 based on response (max 12.6 mg/m2 dose); solution: 4.2 mg/m2 then q 2–4 hr as needed for a total of 4–6 doses/day; increase dose in increments of 2.1 mg/m2 based on response (max 15 mg/m2 dose)
Rx-CIII
Benzodiazepines
Lorazepam (lor A ze pam)
Ativan
Oral, IV
Tablet, injection
0.5–2 mg q 4–6 hr as needed
Rx-CIV
Serotonin Antagonists
Dolasetron (dol A se tron)
Anzemet
Oral, IV
Tablet, injection
100 mg orally within 2 hr before chemotherapy; may be used with dexamethasone, an NK1-receptor antagonist, and olanzapine
Rx
Granisetron (gra NI se tron)
Sancuso, Sustol
IV, oral, transdermal
Injection, tablet, oral liquid, transdermal patch
IV: 10 mg within 30 min before chemotherapy; PO: 1 mg twice daily or 2 mg daily 1 hr before chemotherapy; SUBQ: 10 mg 30 min prior to chemotherapy in combination with dexamethasone or an NK1-receptor antagonist; transdermal: apply 24–48 hr before chemotherapy; remove no sooner than 24 hr after chemotherapy; may be worn up to 7 days
Rx
Ondansetron (on DAN se tron)
Zofran
IV, oral
Injection, tablet, liquid
Postop N/V: 4 mg IV or 8 mg PO
Chemo: 8 mg or 0.15 mg/kg IV or 8 mg BID × 2 doses; schedule and dosing varies depending on chemo regimen.
Rx
Palonosetron (pal oh NOE se tron)
Aloxi
IV
Injection
0.25 mg IV 30 min prior to chemo
Rx
Neurokinin1 Antagonist
Aprepitant (ap RE pi tant)
Emend
Oral
Capsule
130 mg IV 30 min prior to chemotherapy in combination with a serotonin antagonist and dexamethasone
OR
125 mg capsule or 3 mg/kg suspension (max 125 mg/dose) 1 hr prior to chemotherapy, followed by 80 mg once daily for 2 days, in combination with serotonin antagonist and dexamethasone
Rx
Fosaprepitant dimeglumine
(fos ap RE pi tant di ME gloo meen)
Emend
IV
Injection
150 mg 30 min prior to chemotherapy, given in combination with serotonin antagonist and dexamethasone
Rx
Rolapitant
(roe LA pi tant)
Varubi
Oral
Tablet
180 mg 2 hr prior to chemotherapy in combination with dexamethasone, with or without serotonin antagonist
Rx
Miscellaneous Agents
Bismuth subsalicylate (biz muth) (sub sa LIS i late)
Pepto-Bismol, various additional products containing bismuth
Oral
Caplet, liquid, suspension
524 mg q 30–60 min or 1,050 mg q 60 min for up to 2 days (maximum 4,200 mg/24 hr)
OTC
Phosphorated carbohydrate solution
Emetrol
Oral
Liquid
15–30 mL; repeat dose q 15 min until distress subsides; not to be administered over more than 1 hr (5 doses)
OTC
Pyridoxine (peer i DOX een)
Aminoxin, Pyri-500
IM, IV, oral
Capsule, injection solution, liquid, tablet, sustained-release tablet
10–25 mg PO daily 3–4 times daily, alone or in combination with doxylamine
OTC
Erythromycin (er ith roe MYE sin)
Erythrocin, EryPEd, E.E.S., Ery-Tab, others
Oral, IV
Capsule, granules for suspension, injection, powder for suspension, tablet
250–500 mg 3 times daily before meals; 3 mg/kg every 8 hr
Rx
