The safety of antiemetic medications for the prevention of chemotherapy-induced nausea and vomiting.

INTRODUCTION: Chemotherapy-induced nausea and vomiting (CINV) is associated with a significant deterioration in quality of life and is perceived by patients as a major adverse effect of the treatment. The purpose of the review is to determine the safety and efficacy of current antiemetic agents. AREAS COVERED: Information on antiemetic guideline recommended antiemetics derived from PubMed showed that the first and second generation 5-hydroxytryptamine-3 (5-HT3) receptor antagonists have been safe and effective in the control of acute emesis with a small number of patients experiencing mild headache, diarrhea, or constipation. Improvement in the prevention of delayed emesis has occurred with the neurokinin (NK)-1 receptor antagonists aprepitant, netupitant, and rolapitant with mild headache, constipation, hiccups, and fatigue the most commonly reported adverse events. Olanzapine, an antipsychotic that blocks multiple neurotransmitters in the central nervous system, appears to be effective in the prevention of nausea and emesis with mild short term sedation the only reported adverse event. EXPERT OPINION: The current antiemetics that are recommended by the various international antiemetic guidelines are safe and effective in the prevention of chemotherapy-induced nausea and vomiting when used in the recommended doses. Practitioners should consult the antiemetic guidelines for patients receiving chemotherapy.