Prevention of Nausea and Vomiting Associated with Highly Emetogenic Chemotherapy
- PO (Adults): Capsules or suspension — 125 mg given 1 hr prior to chemotherapy (Day 1) (with dexamethasone 12 mg PO given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 80 mg once daily for 2 days (Days 2 and 3) (with dexamethasone 8 mg once daily for 3 days [Days 2–4]).
- IV (Adults): Fosaprepitant — 150 mg given 30 min prior to chemotherapy on Day 1 (with dexamethasone 12 mg PO given 30 min prior to chemotherapy and a 5-HT3 antagonist prior to chemotherapy). Continue dexamethasone on Days 2–4 (8 mg PO on Day 2, 8 mg twice daily on Days 3 and 4); Aprepitant — 130 mg given 30 min prior to chemotherapy on Day 1 (with dexamethasone 12 mg PO given 30 min prior to chemotherapy and a 5-HT3 antagonist prior to chemotherapy). Continue dexamethasone on Days 2–4 (8 mg PO on Day 2, 8 mg twice daily on Days 3 and 4).
- PO (Children
12 yr): Capsules — 125 mg given 1 hr prior to chemotherapy (Day 1) (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 80 mg once daily for 2 days (Days 2 and 3) (with PO dexamethasone at 50% of recommended dose once daily for 3 days [Days 2–4]). - PO (Children 6 mo–<12 yr and >6 kg): Suspension — 3 mg/kg (max dose = 125 mg) given 1 hr prior to chemotherapy (Day 1) (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 2 mg/kg (max dose = 80 mg) once daily for 2 days (Days 2 and 3) (with PO dexamethasone at 50% of recommended dose once daily for 3 days [Days 2–4]).
- IV (Children 12–17 yr and 6 kg): Single–day chemotherapy regimen — 150 mg given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy). Continue dexamethasone on Day 2; Multi–day chemotherapy regimen — 115 mg given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 80 mg PO once daily (capsules) for 2 days (Days 2 and 3) (with PO dexamethasone at 50% of recommended dose once daily for 2 days [Days 2 and 3].
- IV (Children 2–<12 yr and 6 kg): Single–day chemotherapy regimen — 4 mg/kg (max dose = 150 mg) given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy). Continue dexamethasone on Day 2; Multi–day chemotherapy regimen — 3 mg/kg (max dose = 115 mg) given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 2 mg/kg (max dose = 80 mg) (oral suspension) PO once daily for 2 days (Days 2 and 3) (with PO dexamethasone at 50% of recommended dose once daily for 2 days [Days 2 and 3].
- IV (Children 6 mo-<2 yr and 6 kg): Single–day chemotherapy regimen — 5 mg/kg (max dose = 150 mg) given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy). Continue dexamethasone on Day 2; Multi–day chemotherapy regimen — 3 mg/kg (max dose = 115 mg) given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 2 mg/kg (max dose = 80 mg) (oral suspension) PO once daily for 2 days (Days 2 and 3) (with PO dexamethasone at 50% of recommended dose once daily for 2 days [Days 2 and 3].
Prevention of Nausea and Vomiting Associated with Moderately Emetogenic Chemotherapy
- PO (Adults): Capsules or suspension — 125 mg given 1 hr prior to chemotherapy (Day 1) (with dexamethasone 12 mg PO given 30 min prior to chemotherapy and a 5-HT3 antagonist), then 80 mg once daily for 2 days (Days 2 and 3).
- IV (Adults): Fosaprepitant (for delayed nausea/vomiting) — 150 mg given 30 min prior to chemotherapy on Day 1 (with dexamethasone 12 mg PO given 30 min prior to chemotherapy and a 5-HT3 antagonist prior to chemotherapy); Aprepitant (single–dose regimen for delayed nausea/vomiting) — 130 mg given 30 min prior to chemotherapy on Day 1 (with dexamethasone 12 mg PO given 30 min prior to chemotherapy and a 5-HT3 antagonist prior to chemotherapy). Aprepitant (3–day regimen) — 100 mg given 30 min prior to chemotherapy on Day 1 (with dexamethasone 12 mg PO given 30 min prior to chemotherapy and a 5-HT3 antagonist prior to chemotherapy). Continue aprepitant 80 mg PO on Days 2 and 3.
- PO (Children 12 yr): Capsules — 125 mg given 1 hr prior to chemotherapy (Day 1) (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist), then 80 mg once daily for 2 days (Days 2 and 3).
- PO (Children 6 mo–<12 yr and >6 kg): Suspension — 3 mg/kg (max dose = 125 mg) given 1 hr prior to chemotherapy (Day 1) (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 2 mg/kg (max dose = 80 mg) once daily for 2 days (Days 2 and 3) (with PO dexamethasone at 50% of recommended dose once daily for 3 days [Days 2–4]).
- IV (Children 12–17 yr and 6 kg): Single–day chemotherapy regimen — 150 mg given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy). Continue dexamethasone on Day 2; Multi–day chemotherapy regimen — 115 mg given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 80 mg PO once daily (capsules) for 2 days (Days 2 and 3) (with PO dexamethasone at 50% of recommended dose once daily for 2 days [Days 2 and 3].
- IV (Children 2–<12 yr and 6 kg): Single–day chemotherapy regimen — 4 mg/kg (max dose = 150 mg) given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy). Continue dexamethasone on Day 2; Multi–day chemotherapy regimen — 3 mg/kg (max dose = 115 mg) given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 2 mg/kg (max dose = 80 mg) (oral suspension) PO once daily for 2 days (Days 2 and 3) (with PO dexamethasone at 50% of recommended dose once daily for 2 days [Days 2 and 3].
- IV (Children 6 mo-<2 yr and 6 kg): Single–day chemotherapy regimen — 5 mg/kg (max dose = 150 mg) given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy). Continue dexamethasone on Day 2; Multi–day chemotherapy regimen — 3 mg/kg (max dose = 115 mg) given 30 min prior to chemotherapy on Day 1 (with PO dexamethasone at 50% of recommended dose given 30 min prior to chemotherapy and a 5-HT3 antagonist given prior to chemotherapy), then 2 mg/kg (max dose = 80 mg) (oral suspension) PO once daily for 2 days (Days 2 and 3) (with PO dexamethasone at 50% of recommended dose once daily for 2 days [Days 2 and 3].