What is the best antiemetic for chemotherapy?

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Steroids can help to control sickness. They can help particularly with sickness from:

  • increased pressure in the skull (from a brain tumour or secondary cancer in the brain)
  • a blockage in the gut
  • some types of chemotherapy (when used with other anti sickness drugs)

Steroids reduce swelling so they can help to lower pressure in the skull, which causes sickness.

They might reduce swelling around a tumour blocking the gut and help to allow fluids to pass through. This relieves the vomiting that a bowel obstruction can cause. Steroids will only work for a limited time. But they might help until you have other treatment. Or, they can help to make you more comfortable.

Dexamethasone is a steroid that you could have as an injection into a vein just before chemotherapy. You might have steroid tablets to take at home for a couple of days after chemotherapy. 

Dexamethasone can cause difficulty with sleeping and so it’s better if you take it before lunchtime.

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Relative emetogenic potential of chemotherapeutic agents in breast cancer patients (if no antiemetic prophylaxis is used)a

High (emetic risk ≥90%)Intravenous agents
 Cisplatin
Moderate (emetic risk 30%–90%)Intravenous agents
 Carboplatin
 Cyclophosphamide <1500 mg/m2
 Doxorubicin
 Epirubicin
 Combination of AC (doxorubicin and cyclophosphamide)b
Oral agents
 Cyclophosphamide
 Vinorelbine
Low (emetic risk 10%–30%)Intravenous agents
 Gemcitabine
 Liposomal doxorubicin
 Docetaxel
 Paclitaxel
 Methotrexate
 Flurouracil
 Trastuzumab
Oral agents
 Capecitabine
Minimal (emetic risk <10%)Intravenous agents
 Vinorelbine
 Bevacizumab