Total control of chemotherapy induced emesis

A combination of lorazepam, prochlorperazine, dexamethasone, scopolamine and ondansetron was used to prevent and diminish the occurrence of nausea and vomiting during administration of emetogenic chemotherapy. Immediately prior to administering chemotherapy a cutaneous scopolamine patch was applied to the retroaural area, prochlorperazine 5 mg was given orally, and intravenous (IV) lorazepam 0.5 mg, ondansetron 10 mg and dexamethasone 10 mg were given. The last two were repeated after 4 hours twice, and lorazepam at 6 hour intervals for four doses. A chemotherapy course consisted of mitoxantrone 20 mg/m2 i.v., followed by thiotepa 60 mg/m2 followed by 3 grams/m2 of cyclophosphamide as a constant infusion over 48 hours. There were 80 courses given to 30 women and one man with a median age of 42 years (29-58). Complete protection from vomiting in all 80 courses resulted. Minor nausea occurred in 25 courses. The antiemetic regimen was well tolerated and all patients received all the doses as prescribed.