Other MEC (included carboplatin
(<4 mg/ml/min):
None a 5-HT 3 RA and Dex for select
patients with additional risk factors
or who have failed previous therapy
with 5-HT 3 antagonist plus steroid
• Option C:
Olanzapine
Acute phase:
Single dose antiemetic, such as Dex
or 5-HT 3 RA Acute phase:
Single dose antiemetic, such
as Dex or 5-HT 3 RA; or MCP or
prochlorperazine
Delayed phase:
No routine prophylaxis Delayed phase:
No routine prophylaxis
No routine prophylaxis No routine prophylaxis
been introduced to the market
in the past decade. The field of
antiemetic drug development is
still very active, and newer NK 1
RAs have recently come onto
the market besides the initial
one, that of aprepitant (and its
IV formulation, fosaprepitant),
rolapitant, and netupitant
(which is only available in fixed
combination with palonosetron
as NEPA). There are multiple
trials published for each of these
agents and the information that
is becoming available on their
antiemetic efficacy as well as that of other classes of drugs is
multiplying rapidly. 14 Because
there are so many antiemetic
treatment options, it is difficult
for some clinicians to identify
the best evidence available,
as it would need a significant
amount of time and dedication
to the particular symptoms on
an ongoing basis, which is not
feasible as the management
of these two symptoms is only
a small part of the clinicians’
workload, who often work in very
busy clinics. Also, some clinicians
change their practice very slowly
hospitalpharmacyeurope.com | 2019 | 23