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Childhood Cancer

Antinausea drugs used during chemotherapy

Antinausea drugs, also referred to as antiemetics, make chemotherapy treatments more bearable, but they sometimes cause side effects. This section lists the most commonly used antinausea drugs. Other less commonly used drugs to prevent nausea are not described here (e.g., Marinol®, Reglan®, scopolamine patch, and Atarax®).

Antinausea drug list

As with chemotherapy drugs, several different names can be used to refer to each antinausea drug. The list below will help you find detailed information about each drug on the following pages.

Drug name Brand name(s)
Aprepitant Emend®
Diphenhydramine Benadryl®
Granisetron Granisol®, Kytril®, Sancuso®
Lorazepam Ativan®
Ondansetron Zofran®
Prochlorperazine Compazine®
Promethazine Phenergan®

Aprepitant (a-PREP-it-ant)

How given: Capsule by mouth (PO) or intravenous (IV) infusion

When given: Capsule is taken 1 hour before chemotherapy. IV infusion is given over a 15-minute span, starting 30 minutes before chemotherapy.

Precaution: This drug interacts with many drugs, so make sure the pharmacist knows about every drug your child takes.

Common side effects:

•  Fatigue

•  Dizziness

•  Constipation

•  Diarrhea

•  Hiccups

•  Heartburn

•  Itchiness

•  Loss of appetite

Diphenhydramine (die-fen-HIGH-dra-meen)

How given: Liquid, pills, or capsules by mouth (PO), or intravenous (IV) injection

When given: Usually given every 6 to 8 hours

Common side effects:

•  Drowsiness

•  Dizziness

•  Impaired coordination

•  Dry mouth

•  Excitability (in young children)

•  Low blood pressure

Our go-to drugs for nausea and vomiting are Zofran® and Benadryl®. But, 9-month-old Wyatt was hospitalized when he couldn’t stop throwing up even on those two meds, so they also gave him Ativan® and Reglan® while he was inpatient. We just had a 3-week break from treatment and he gained a pound a week. It was depressing to go back in, but they didn’t want to stop treatment for longer than 3 weeks.

Granisetron (gran-ISS-eh-tron)

How given: Intravenous (IV) injection, pills by mouth (PO), or a patch on the skin

When given: Granisetron is usually given 30 minutes before the start of chemotherapy infusion. Doses may be repeated every 12 to 24 hours.

Common side effects:

•  Headaches

•  Diarrhea

•  Constipation

Infrequent side effects:

•  High blood pressure

•  Fatigue

•  Fever

•  Allergic reaction

•  Abnormal heart rhythms

Sarah got Zofran® at first, then the clinic switched to liquid Kytril®. Sarah usually hates liquid meds (she much prefers pills), but she loves Kytril®. She thinks it’s really yummy. And it works, too!

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Kytril® is an antinausea pill. It is incredibly expensive but brilliant in treating chemo-related sickness. It sometimes takes a bit of juggling to get the timing right; Michael used to take it an hour before taking the pills at bedtime. None of the other antiemetics worked for him nearly as well.

Lorazepam (lor-AZ-a-pam)

How given: Pills or liquid by mouth (PO), sublingually (pill dissolved under the tongue), or subcutaneous (Sub-Q), intravenous (IV), or intramuscular (IM) injection

When given: This tranquilizer is generally given in combination with other antinausea drugs.

Precaution: This drug interacts with several other drugs, so parents should tell the doctor about everything else their child is taking, including over-the-counter drugs.

Common side effects:

•  Drowsiness and sleepiness

•  Poor short-term memory

•  Impaired coordination

•  Low blood pressure

•  Excitability (in young children)

Ondansetron (on-DAN-se-tron)

How given: Intravenous (IV) injection, liquid or pills by mouth (PO), or sublingual (pill dissolved under the tongue)

When given: Usually given 30 minutes prior to chemotherapy drugs, then every 4 to 8 hours until nausea ends. Can be given in a higher dose once a day.

Note: Ondansetron comes in flavored oral solutions; 1 teaspoon = 4 mg. You can mix the dose in a small amount of a drink your child likes.

Common side effects:

•  Headache with rapid IV administration

•  Diarrhea

•  Constipation

Infrequent side effects:

•  Serious allergic reaction

•  Abnormal heart rhythm

After Jeremy had his first outpatient chemo, every couple hours he would vomit. The next morning, when his oncologist asked him how it had gone, Jeremy was hesitant to tell him about the vomiting. When he did, the doctor asked us if the Zofran® hadn’t helped. I gave him a confused look and asked him what a Zofran® was. I can laugh about it now, but it was an oversight. Everyone thought someone else had taken care of it! We rarely had any problems with nausea after that.

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The absolute best for me were the Zofran® lozenges: simply dissolve on or under the tongue for instant relief. The prescription must state lozenges. You’ll love those “melty pills.”

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Ondansetron works great for Ethan. He does have late nausea after chemo, so he takes it once a day for 10 days afterwards, and hasn’t vomited or felt nauseated.

Prochlorperazine (pro-chlor-PAIR-a-zeen)

How given: Pills, long-acting capsule, or liquid by mouth (PO); rectal suppository; or intramuscular (IM) or intravenous (IV) injection

When given: Used when mild nausea is expected.

Common side effects:

•  Drowsiness

•  Low blood pressure

•  Nervousness and restlessness

•  Uncontrollable muscle spasms, especially of the jaw, face, and hands

•  Blurred vision

Promethazine (pro-METH-ah-zeen)

How given: Pills or liquid by mouth (PO), rectal suppository, or intramuscular (IM) or intravenous (IV) injection

When given: Usually given every 4 to 6 hours.

Common side effects:

•  Drowsiness

•  Dizziness

•  Impaired coordination

•  Fatigue

•  Blurred vision

•  Euphoria

•  Insomnia

Colony-stimulating factorsDrugs used to relieve pain

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