What are the Oncology Nursing Society (ONS) treatment guidelines for chemotherapy-induced nausea and vomiting (CINV)?

Updated: May 31, 2018
  • Author: Winston W Tan, MD, FACP; more...
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The ONS practice recommendations for CINV in adults include the following [4] :

  • Cannabis/cannabinoids
  • Dexamethasone-sparing regimen
  • Netupitant-palonosetron combination (NEPA)
  • NK1 RA
  • Olanzapine
  • 5-HT3 RA
  • Sustained-release granisetron
  • Transdermal granisetron
  • Triple drug regimen: NK1 RA + 5-HT3 RA + DEX

In addition, the following treatments were considered by ONS likely to be effective:

  • Adherence to CINV guidelines
  • Benzodiazepine for anticipatory CINV
  • Gabapentin
  • Hypnosis for anticipatory CINV
  • Managing patient expectations
  • Olanzapine for breakthrough CINV
  • Oral palonosetron
  • Progestins
  • Progressive muscle relaxation and guided imagery
  • Single-agent dexamethasone

The ONS considered the benefits balanced with harm for virtual reality, which has been evaluated for providing distraction and reducing anxiety as means of CINV prevention.

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