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Antiemetic treatment for children undergoing chemotherapy

Implementation

Antiemetic treatment should be started before the chemotherapy.

  • For moderate emetic activity - give ondansetron intravenously or orally 15-30 minutes before starting and thereafter 2-3 times daily. Tropisetron may be given once daily for children > 10 years.
  • For high emetic activity - give ondansetron intravenously 15 minutes before starting chemotherapy. Repeat after 2-4 hours and thereafter every 8 hours. Dexamethazone is given together with the first dose of ondansetron (only once). 
  • In special cases, these can be tried:
    • dexchlorpheniramine orally or intravenously
    • promethazine orally or intravenously
    • diazepam orally or intravenously x 2–3 times daily
    • chlorpromazine orally 
  • For intensive nausea, antiemetics should be given regularly until the day after chemotherapy is finished.
  • For chemotherapy drugs causing delayed nausea, the antiemetic treatment should be extended 3-5 days after concluded chemotherapy treatment. 
  • Good hydration can help to soothe nausea.

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