Dosing & Uses
Dosage Forms & Strengths
capsules
- 300mg
injectable solution
- 100mg/mL
Emesis
300 mg PO q6-8hr OR
200 mg IM q6-8hr
Renal Impairment
CrCl ≤70 mL/min/1.73 m2: Reduce dose or increase dosing interval; adjust dose as necessary based on patient response; monitor renal function closely
CrCl>70 mL/min/1.72 m2: No adjustments provided by manufacturer
Dosage Forms & Strengths
capsules
- 300mg
Emesis
20 mg/kg/day PO divided q6-8hr
Consider lower initial dose
Emesis
300 mg PO q6-8hr OR
200 mg IM q6-8hr
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Adverse Effects
Frequency Not Defined
Dizziness
Parkinson-like symptoms
Sedation
Headache
Hypersensitivity reactions
Irritation at injection site
Warnings
Contraindications
Hypersensitivity to drug or excipients
Cautions
EPS and other CNS symptoms, which can occur in patients treated with may be confused with CNS signs of undiagnosed primary disease (eg, encephalopathy, metabolic imbalance, Reye’s syndrome); if CNS symptoms occur, evaluate risks and benefits of continuing therapy
Serious CNS adverse reactions such as coma, depression of mood, disorientation, and seizures reported; recent use of other drugs that cause CNS depression or EPS symptoms (eg, alcohol, sedatives, hypnotics, opiates, anxiolytics, antipsychotics, and anticholinergics) may also increase risk for these serious CNS reactions; consider reducing daily dosage by increasing dosing interval or discontinuing drug
Therapy is potentially hepatotoxic; avoid use in patients whose signs and symptoms suggest presence of hepatic impairment; discontinue therapy in patients who develop impaired liver function while receiving drug
Therapy can cause drowsiness and may impair mental and/or physical abilities needed to perform hazardous tasks (driving a motor vehicle or operating machinery); choose therapy over concomitant use of other drugs that cause CNS depression or EPS symptoms (eg, alcohol, sedatives, hypnotics, opiates, anxiolytics, antipsychotics, and anticholinergics), depending on importance of drug to patient
Inform patients not to operate motor vehicles or other dangerous machinery until they are reasonably certain that therapy does not affect them adversely
Extrapyramidal symptoms
- Extrapyramidal symptoms (EPS), manifested primarily as acute dystonic reactions, may occur; dystonic reactions may include sudden onset of muscular spasms, especially in the head and neck or opisthotonos
- Other EPS include laryngospasm, dysphagia, and oculogyric crisis; involuntary spasms of tongue and mouth may lead to difficulty in speaking and swallowing; anticholinergic drugs can be used to treat acute dystonic reactions
- EPS may include akathisia, restlessness, akinesia, and other parkinsonian-like symptoms (eg, tremor); depending on severity of symptoms, reduce daily dosage by increasing dosing interval or discontinue therapy
- Avoid using drug in patients receiving other drugs that are likely to cause EPS (eg, antipsychotics)
Pregnancy & Lactation
Pregnancy
Limited available data in pregnant women are not sufficient to inform a drug-associated risk for major birth defects and miscarriage
Animal data
- No adverse developmental effect observed in animal reproduction studies with administration of therapy during organogenesis in pregnant rats at doses 0.16 and 0.8 times the recommended human dose (RHD) and in pregnant rabbits at doses 1.6 times the RHD
Lactation
There is no information on presence of drug in human milk, effects of drug on breastfed infant or on milk production; lack of clinical data during lactation precludes clear determination of risk of drug to infant during lactation
Consider developmental and health benefits of breastfeeding along with mother's clinical need for therapy and any potential adverse effects on breastfed infant from drug or from underlying maternal condition
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Unclear, the drug appears to directly affect medullary chemoreceptor trigger zone by inhibiting emetic stimuli to the vomiting center
Pharmacokinetics
Onset: 15-35 min (IM), 10-40 min (PO)
Duration: 2-3 hr (IM), 3-4 hr (PO)
Bioavailability: BA of oral dose equals 60-100% of IM dose
Half-life elimination: 7-9hr
Metabolism: Liver
Metabolites: N-desmethyl & N-oxide derivatives
Excretion: Urine (30-50%), feces via bile
Images
Patient Handout
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
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Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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- Compare formulary status to other drugs in the same class.
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