Cost-effective use of 5-HT3-receptor antagonist therapy

J. Koeller, S. M. Grunberg

    Research output: Contribution to journalReview articlepeer-review


    Clinical trials with granisetron, ordansetron, and dolasetron clearly demonstrate the appropriateness of single-dose IV therapy - a therapeutic range of 8 to 32 mg for ondansetron, 10 to 160 μg/kg for granisetron, and 0.6 to 5 mg/kg for dolasetron. Oral administration is also strongly supported at dosages of 16 to 24 mg for ondansetron, 1 to 2 mg for granisetron, and 200 mg for dolasetron whenever reimbursement covers the use of oral formulations. Dexamethasone should be added to the antiemetic regimen routinely; it can significantly increase efficacy at a small additional cost and may even allow lower doses of the 5-HT3-receptor antagonists to be used. Physician education is still needed at institutions where these drugs are prescribed in excessive dosages or on an as-needed basis. The proper use of 5-HT3-receptor antagonists clearly must be based on study findings rather than on subjective perceptions about how much drug is needed to prevent or substantially reduce emesis in patients undergoing chemotherapy. Improper use of antiemetics can easily triple the treatment costs for patients with cancer.

    Original languageEnglish (US)
    Pages (from-to)48s-54s
    JournalP and T
    Issue number7 SUPPL.
    StatePublished - Dec 1 1997

    ASJC Scopus subject areas

    • Pharmacology (medical)


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