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Chemotherapy induced nausea and vomiting (CINV) is a distressing symptom for cancer patients. Nausea is used to describe the sensation of feeling sick, whereas vomiting describes being sick.
CINV is experienced by up to 75% of all cancer patients. Management is important to improve nutritional status of patients and quality of life.
CINV can be classified according to time of onset:
Specific chemotherapy regimens are associated with high risk of CINV without anti-sickness medication.
Drugs commonly associated with CINV include:
It is occasionally difficult to distinguish CINV from nausea and vomiting caused by cancer itself. The best distinguishing factor is the time of symptom onset.
Chemotherapy Induced Nausea and Vomiting Treatment
Serotonin receptor antagonists (e.g. ondansetron, granisetron, palonosetron) form the basis of treatment for CINV. Dexamethasone and aprepitant are other effective anti-sickness medications for CINV. Other classes of anti-sickness medications are commonly used in combination with the above drugs.
Medicinal cannabis can be considered when first line therapies have not achieved adequate symptom control.
