Consensus proposal for 5HT3 antagonists in the prevention of acute emesis related to highly emetogenic chemotherapy. Dose, schedule, and route of administration

David R. Gandara, Fausto Roila, David Warr, Martin J. Edelman, Edith A. Perez, Richard J. Gralla

Research output: Contribution to journalReview article

47 Scopus citations


Selective antagonists to the Type 3 serotonin receptor (5HT3) in combination with corticosteroids are now considered the standard of care for the prevention of emesis from moderately to highly emetogenic chemotherapy. Here we address issues of optimal dose, schedule and route of administration of four currently available selectable 5HT3 antagonists. This paper utilizes an evidence based medicine approach to the literature regarding this class of drugs, emphasizing the results large, randomized, controlled trials to make formal recommendations concerning optimal use of this important new class of anti-emetic agents. We conclude that for each drug there is a plateau in therapeutic efficacy at a definable dose level above which further dose escalation does not improve outcome. Furthermore, a single dose is as effective as multiple doses or continuous infusion, and finally, emerging data demonstrate that the oral route is equally efficacious as the intravenous route of administration, even with highly emetogenic chemotherapy.

Original languageEnglish (US)
Pages (from-to)237-243
Number of pages7
JournalSupportive Care in Cancer
Issue number3
StatePublished - May 1 1998



  • Chemotherapy induced emesis
  • Dolesetron
  • Granisetron
  • Ondansetron
  • Serotonin receptors
  • Tropisetron

ASJC Scopus subject areas

  • Oncology

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