Chemotherapy-induced nausea and vomiting prophylaxis
Nausea and vomiting induced by anticancer chemotherapy. Prophylaxis uses a three-drug regimen: 5-HT3 antagonist, NK1 antagonist, and dexamethasone.
ICD-10 R112 drugs
Also known as: CINV prophylaxis, Antiemetic prophylaxis
Drugs used for this condition
- ADexamethasoneAdd-on therapy · GlucocorticoidsComponent of standard triple antiemetic regimen for chemotherapy. Per ASCO and NCCN guidelines, dexamethasone is given with a 5-HT3 receptor antagonist and an NK1 receptor antagonist. Doses 8–20 mg depending on the emetogenicity of the regimen.
- CMirtazapineCase-by-case decision · Other antidepressants (NaSSA)Off-label mirtazapine 15–30 mg at bedtime in oncology patients with nausea, anorexia, insomnia, and depression is a common palliative practice per NCCN. 5-HT3 antagonism (like ondansetron) and H1 antagonism explain antiemetic and appetite-stimulating effects. Not first-line CINV therapy.
How to read tiers A–F
Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.
- AStrong evidence – first or second line in international guidelines
- BRecommended in selected cases
- CStudy data contradict each other
- DBenefit not proven, no documented harm
- FDocumented harm, or risk without benefit