[On what indication should serotonin antagonists be used? A retrospective study of the use of ondansetron at an oncologic unit]

561 chemotherapy-cycles administered to 191 patients during the period 1990-92 at the University Hospital, Tromsø, were retrospectively analysed for combination with ondansetron. 65% of the cycles were combined with ondansetron. The frequency increased from 1991 (50%) to 1992 (69%). Among moderate emetogenic regimens (MIME, MMM, High-dose MTX, EBVP, ELF) the frequency had changed from 44% to 91%. The increased ondansetron-treatment in moderate emetogenic regimens raised the total cost of treatment. Better cost-effectiveness can possibly be achieved by "low dose-ondansetron" (4 mg x 2) and more frequent supplementary use of diazepam, corticosteroids or haloperidol. Use of ondansetron regimens extending beyond 24 hours is not cost-effective. Peroral treatment is less expensive and usually adequate to control acute emesis.