Antiemetic therapy should be administered throughout the duration of the chemotherapy protocol and to cover delayed nausea. The acute and delayed emetic risk of multi-day chemotherapy protocols will overlap depending on the individual drugs and their sequence of administration. More or less antiemetic cover may be required.
MASCC Guidelines 2016 classify procarbazine as HIGHLY emetogenic, but in clinical practice a moderate antiemetic regimen may be sufficient to control nausea and/or vomiting. Omission of 5HT3 antagonist for subsequent doses of procarbazine may be considered depending on the patient's emetogenic response to the treatment
Suggested default antiemetics have been added to the treatment schedule, and may be substituted to reflect institutional policy.
As a steroid has been included as part of this protocol, additional antiemetic steroids are not required.
Ensure that patients also have sufficient antiemetics for breakthrough emesis:
Metoclopramide 10 mg three times a day when necessary (maximum of 30 mg/24 hours, up to 5 days) OR
Prochlorperazine 10 mg PO or 12.5 mg IV every 6 hours when necessary.