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Second-line Antiemetics

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Levomepromazine (Methotrimeprazine)

Dexamethasone

Prochlorperazine

Hyoscine (Scopoderm TTS™)

Lorazepam

Ondansetron

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Levomepromazine (Methotrimeprazine)

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Dexamethasone

See also: Corticosteroids

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Prochlorperazine

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Hyoscine (Scopoderm TTS™)

Note: Scopoderm TTS™ patches incur a part charge at community pharmacies but if used 'in the control of intractable nausea, vomiting, or inability to swallow saliva in the treatment of malignancy or chronic disease', a special authority number can be applied for. Often there are supply problems which cause lack of availability. See PHARMAC website.

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Lorazepam

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Ondansetron

The serotonin (5HT3) antagonists, e.g., ondansetron, have proven benefit in chemotherapy and radiation induced emesis BUT are NOT generally prescribed in the treatment of vomiting in Palliative Care patients due to limited evidence of benefit.

Regular ondansetron use causes significant constipation.

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Topic Code: 4088