Key: + = scored; del-rel = delayed-release; ext-rel = extended-release; MDD = major depressive disorder; ODT = orally-disintegrating tablet; sust-rel = sustained-release; TRD = treatment-resistant depression

¹ As adjunct to antidepressants.

² Not as first-line therapy. Use in patients refractory to other antidepressants.

³ MDD with acute suicidal ideation or behavior.

⁴ For TRD, defined as MDD in patients who failed to respond to 2 or more separate trials of different antidepressants of adequate dose and duration in the current episode.

⁵ Not for treatment initiation. Use other forms of bupropion for initial dose titration.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

Created 11/2023

Key: IgG = immunoglobulin G; IGIV = immune globulin intravenous; IGSC = immune globulin subcutaneous; IV = intravenous; SC = subcutaneous

¹ Congenital or X-linked agammaglobulinemia, common variable immunodeficiency, Wiskott-Aldrich syndrome, or severe combined immunodeficiencies.

² Other indications for immune globulins include, but not limited to, chronic immune thrombocytopenic purpura (ITP), chronic inflammatory demyelinating polyneuropathy (CIPD), and dermatomyositis (DM).

³ Sucrose- and preservative-free.

⁴ Risk of renal dysfunction/failure, volume overload, or thrombosis: give at the minimum dose and/or infusion rate practicable; see full labeling.

⁵ Sucrose-, maltose-, preservative- and latex-free.

⁶ Contains maltose; sucrose- and preservative-free.

⁷ Caprylate/chromatography purified.

⁸ Contains L-proline.

⁹ Give by using an infusion pump into abdomen, thigh, upper arm, and/or lateral hip areas. Prior to treatment, obtain serum IgG trough level to guide subsequent dose adjustments.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

Created 9/2023

Key:CSF = cerebrospinal fluid; PCV = pneumococcal conjugate vaccine; PPSV = pneumococcal polysaccharide vaccine

 ¹ Also applies to receipt of PCV7 at any age and no other pneumococcal vaccines.

 ² The minimum interval for PPSV23 is ≥1yr since last PCV13 dose and ≥5yrs since last PPSV23 dose.

 ³ Based on shared clinical decision-making with the patient, vaccine providers may choose to administer PCV20 to those who have already completed the series with PCV13 and PPSV23.

 ⁴ Immunocompromising conditions include chronic renal failure, congenital or acquired asplenia, congenital or acquired immunodeficiency (eg, B- or T-lymphocyte deficiency, complement deficiencies [particularly C1, C2, C3, and C4 deficiencies], phagocytic disorders [excluding chronic granulomatous disease]), generalized malignancy, HIV infection, Hodgkin disease, iatrogenic immunosuppression (eg, treatment with immunosuppressants, including long-term systemic corticosteroids, radiation), leukemia, lymphoma, multiple myeloma, nephrotic syndrome, sickle cell disease/other hemoglobinopathies, solid organ transplant.

 ⁵ The minimum interval for PPSV23 is ≥8wks since last PCV13 dose and ≥5yrs since last PPSV23 dose in adults ≥65yrs with an immunocompromising condition, cochlear implant, or CSF leak, or in adults 19–64yrs with immunocompromising condition.

 ⁶ Review pneumococcal vaccine recommendations again when patient turns 65yrs old.

 ⁷ No vaccines recommended at this time.

 ⁸ Chronic medical conditions include alcoholism, chronic heart disease (eg, CHF, cardiomyopathies), chronic liver disease, chronic lung disease (eg, COPD, emphysema, asthma), cigarette smoking, diabetes.

 ⁹ Adults with chronic medical conditions were previously not recommended to receive PCV13.

Centers for Disease Control and Prevention. Pneumococcal Vaccine Timing for Adults. Accessed March 15, 2023. https://www.cdc.gov/vaccines/vpd/pneumo/downloads/pneumo-vaccine-timing.pdf.

Created 6/2023

Key:CHF = congestive heart failure; COPD = chronic obstructive pulmonary disease; IM = intramuscular; inh = inhalation; inj = injection; liq = liquid; pwd = powder; RSV = respiratory syncytial virus; soln = solution; susp = suspension

 ¹ Not established for treatment of RSV disease. Indications for use in pediatric patients include: with a history of premature birth
(≤35 weeks gestational age) and who are ≤6mos of age at the beginning of RSV season; with bronchopulmonary dysplasia
that required medical treatment within the previous 6mos and who are ≤24mos of age at the beginning of RSV season; with hemodynamically significant congenital heart disease and who are ≤24mos of age at the beginning of RSV season.

 ² The American Academy of Pediatrics (AAP) recommends the use of ribavirin to be based on clinical circumstances, patient factors and risks, and in patients with severe disease or those at risk for severe disease (eg, immunocompromised, hemodynamically significant cardiopulmonary disease). They also recommend its use in the immunocompromised or transplant high-risk groups with or without palivizumab.

 ³ Contraindicated in pregnancy

Centers for Disease Control and Prevention. Respiratory Syncytial Virus Infection (RSV): For Healthcare Providers. Accessed June 20, 2033. https://www.cdc.gov/rsv/clinical/index.html.

Eiland LS. Respiratory syncytial virus: diagnosis, treatment and prevention. J Pediatr Pharmacol Ther. 2009 Apr;14(2):75-85. doi: 10.5863/1551-6776-14.2.75. PMID: 23055894; PMCID: PMC3461981.

Created 9/2023

Key: IM = intramuscular; PCV = pneumococcal conjugate vaccine; PPSV = pneumococcal polysaccharide vaccine; SC = subcutaneous

¹ Serotypes of Streptococcus pneumoniae.

² Contraindicated in patients with allergy to any diphtheria toxoid-containing vaccine, aluminum phosphate, polysorbate 80 (polysorbate 20 for Vaxneuvance).

³ Also indicated for the prevention of otitis media due to serotypes 4, 6B, 9V, 14, 18C, 19F, and 23F.

⁴ Incomplete series of another pneumococcal conjugate vaccine.

⁵ The Advisory Committee on Immunization Practices (ACIP) has recommendations for revaccination against pneumococcal disease for patients at high risk who were previously vaccinated with Pneumovax 23. Routine revaccination of immunocompetent patients previously vaccinated with a 23-valent vaccine is not recommended.

⁶ Contraindicated in patients with allergy to phenol.

⁷ Indicated for patients aged ≥2yrs who are at increased risk for pneumococcal disease.

(Rev. 9/2023)

¹ Add-on maintenance in patients with inadequate response to nasal steroids.

² Add-on maintenance of chronic rhinosinusitis with nasal polyps (CRSwNP) in patients with inadequate response to nasal steroids.

³ For prophylaxis of nasal polyp recurrence.

⁴ For nasal polyps in patients who have had ethmoid sinus surgery. To be used by trained physicians for placement in ethmoid sinus under endoscopic visualization.

Not an inclusive list of medications or dosing details. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

Created 1/2023

Key: CDI = Clostridioides difficile infection

¹ The IDSA/SHEA clinical practice guideline on the management of CDI recommends fidaxomicin over vancomycin as the preferred treatment for the first occurrence of CDI due to its safety and efficacy profile. Vancomycin is an accepted alternative, and metronidazole may be used if fidaxomicin and vancomycin are unavailable.

² For the treatment of fulminant CDI, defined as the presence of hypotension, shock, ileus, or megacolon, consult the IDSA/SHEA clinical practice guideline on the management of CDI for its recommendation on vancomycin and metronidazole use.

³ The use of metronidazole for CDI is not an FDA-approved indication, however, the IDSA/SHEA guideline recommends off-label use as an alternative for non-severe CDI (eg, WBC ≤15,000 cells/µL and serum creatinine <1.5mg/dL) if fidaxomicin and vancomycin are unavailable.

⁴ For alternative dosing (eg, fidaxomicin extended regimen, tapered/pulsed vancomycin regimen) and off-label therapies (eg, rifaximin, fecal microbiota transplantation) for recurrent CDI, consult the IDSA/SHEA clinical practice guideline on the management of CDI.

⁵ Consider standard dosing (125mg 4 times daily) if metronidazole was used for first CDI episode.

⁶ Use only in conjunction with antibacterial drug treatment of CDI to reduce CDI recurrence in patients at high risk for recurrence (eg, age ≥65yrs, immunocompromised [per history or use of immunosuppressants], and severe CDI on presentation). Caution in patients with CHF.

⁷Use after the completion of antibiotic treatment for recurrent CDI to prevent CDI recurrence.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

Johnson S, Lavergne V, Skinner AM, Gonzales-Luna AJ, Garey KW, Kelly CP, Wilcox MH. Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults. Clinical Infectious Diseases. 2021;73(5):e1029–e1044. https://doi.org/10.1093/cid/ciab549.

(Rev. 9/2023)

Key: CrCl = creatinine clearance; EE = erosive esophagitis; H2RA = histamine 2 receptor antagonists; NERD = nonerosive reflux disease; ODT = orally-disintegrating tabs; PPI = proton pump inhibitor

 ¹ The ACG guidelines recommend that patients with classic and no alarm symptoms should be first treated with an 8-week trial of empiric PPIs once daily, 30−60mins before a meal (twice daily for 8−12wks before additional testing if patient has both extraesophageal and classic symptoms). If no response to therapy, switch only once to another PPI. For refractory GERD, defined as persistent heartburn and/or regurgitation despite 8wks of twice daily PPI (12wks for some), optimization of PPI therapy is recommended as the first step of management. Discontinue PPI if off-therapy reflux testing is negative unless other indication for PPI use exists. Refer to the estimated relative acid-suppression potencies of individual PPIs standardized to omeprazole when switching or optimizing therapy: pantoprazole (0.23), lansoprazole (0.90), omeprazole (1.00), esomeprazole (1.60), and rabeprazole (1.82).

 ² The ACG guidelines recommend an intermittent or as needed PPI therapy for heartburn symptom control in NERD. Step-down therapy to H2RAs is acceptable.

 ³ PPIs should be discontinued if symptoms resolve (consider on-demand PPI if symptoms occur) and without EE or Barrett’s esophagus, however, indefinite maintenance PPI therapy is recommended for patients with LA grade C or D esophagitis.

 ⁴ PPIs are recommended over H2RAs for healing EE and maintenance of healing for EE.

 ⁵ The addition of as needed H2RA at bedtime may be beneficial in patients with nocturnal symptoms and those with objective evidence of nocturnal acid reflux on pH monitoring despite PPI treatment.

 ⁶ For the 40mg twice daily regimen for EE healing, reduce to 40mg once daily for CrCl 30–60mL/min or 20mg once daily for CrCl <30mL/min.

 ⁷ Doses over 1mg/kg/day have not been studied in patients 1–11yrs. Doses over 1.33mg/kg/day have not been studied in patients 1mo–<1yr.

 ⁸ Use in pregnancy only if clearly needed. Avoid in nursing mothers or children under 16yrs.

 ⁹ Antacids are recommended to be used exclusively for on-demand symptom relief. First-line therapy in pregnant patients when lifestyle modifications fail.

¹⁰ Avoid in patients with allergy to salicylates (including aspirin) or concomitant salicylate products.

¹¹ Consider additional 4wks if benefit outweighs potential risks.

Not an inclusive list of medications. Please see drug monographs at www.eMPR.com and/or contact company for full drug labeling.

Key: IM = intramuscular; SC = subcutaneous

 ¹ Because some protection is provided by 1 or 2 doses, the vaccine series should be initiated, if indicated, even if it cannot be completed before departure. An approved accelerated vaccination schedule can be used for people traveling on short notice who face imminent exposure or for emergency responders to disaster areas.

 ² Adults aged 18–65yrs can receive the 2nd dose as early as 7 days after the 1st dose.

 ³ Recommended for persons moving to JE-endemic country to live longer-term (1 month or longer), frequent travelers, and shorter-term travelers with an increased risk based on travel duration, season, location, activities, and accommodations. Consider vaccination for travelers to endemic areas with uncertain travel plans.

 ⁴ Meningitis serogroup B disease is extremely rare in “meningitis belt” countries, therefore, MenB vaccine (Trumenba, Bexsero) is not recommended for travelers.

 ⁵ Children who completed the primary dose or series before 7yrs old should receive a booster dose after 3yrs and repeated every 5yrs thereafter if living or traveling to a hyperendemic area. If received the primary dose or series at ≥7 years of age, a booster dose should be given after 5yrs and every 5yrs thereafter.

 ⁶ Travelers to the Kingdom of Saudi Arabia for Umrah or Hajj must provide evidence of vaccination ≥10 days and no more than 3yrs (polysaccharide vaccine) or 5yrs (conjugate vaccine) before arrival.

 ⁷ Countries in the “meningitis belt” include Ethiopia, Sudan, Chad, Nigeria, Burkina Faso, Mali, Guinea, Senegal, Gambia, etc. Travelers to these areas should be vaccinated with MenACWY vaccine before travel esp. during the dry season (December-June).

 ⁸ Travelers with HIV, anatomic or functional asplenia, persistent complement component deficiencies (C3, C5-9, properdin, factor D or H), or on eculizumab therapy should receive 2-dose series 8–12wks apart. Although not indicated for use above age 55yrs, Menveo and Menactra are the recommended vaccines for this age group since Menomune is no longer available in the US.

 ⁹ If the age-appropriate series is not completed before travel, the remaining IPV doses to complete the series should be given when feasible, at the following intervals: for children, 1st dose at age ≥6wks; 2nd and 3rd doses should be ≥4wks after the previous doses; 3rd and 4th doses should be ≥6mos apart. For children completing the accelerated schedule, a dose at age ≥4yrs should still be given, as long as it has been ≥6mos after the previous dose.

¹⁰ Long-term travelers and residents may be required to show proof of polio vaccination (International Certificate of Vaccination or Prophylaxis) when departing from these countries. Polio vaccine must be received between 4wks and 12mos before the date of departure from the polio-affected country.

¹¹ Travelers visiting areas where rabies is enzootic and immediate access to medical care (eg, biologics) is limited. Preexposure vaccination may be recommended based on the occurrence of rabies in the country of destination, the intended activities of the traveler (eg, veterinarians, research workers, animal control) esp. in remote areas, duration of stay, and the likelihood of repeat travel to at-risk destinations or long-term travel to a high risk destination.

¹² Due to the risk of serious adverse events after vaccination, clinicians should only vaccinate those who are at risk of exposure to YF virus or who require proof of vaccination to enter a country. Contraindications to the vaccine include: acute hypersensitivity to egg or chick embryo protein, or any component of the formulation (eg, gelatin), infants <9mos, severe immunosuppression (eg, HIV, leukemia, lymphoma, thymic disease, generalized malignancy, or drug- or radiation-induced immunosuppression), breastfeeding to infants <9mos.

¹³ A proof of yellow fever vaccination (International Certificate of Vaccination or Prophylaxis) is required to enter the following African countries: Angola, Benin, Burkina Faso, Burundi, Cameroon, Central African Republic, Republic of the Congo, Côte d’Ivoire, Democratic Republic of Congo, Gabon, Ghana, Guinea-Bissau, Mali, Niger, Sierra Leone, South Sudan, Sudan, Togo, Uganda; and French Guiana. Some countries require vaccination if traveling from a country with risk of YF virus transmission, including transit >12hrs in an airport located in a country with risk of YF virus transmission (eg, South Africa, Australia, Bahamas). For a list of country-specific entry requirements and recommendations, refer to the CDC Yellow Book.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

Key: ART = assisted reproductive technology; FSH = follicle stimulating hormone; GnRH = gonadotropin-releasing hormone; hCG = human chorionic gonadotropin; IM = intramuscular; IU = international units; IUI = intrauterine insemination; IVF = in vitro fertilization; LH = luteinizing hormone; PCOS = polycystic ovary syndrome; PID = pelvic inflammatory disease; SC = subcutaneous.

¹ To be used with timed intercourse or ART.

² Not FDA-approved but has been successfully used in IVF for years (off-label use).

³ Patient must not be pregnant at start of treatment.

Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

Ordonez ND. Infertility. In: O’Connell M, Smith JA. eds. Women’s Health Across the Lifespan, 2e. McGraw Hill; 2019.

World Health Organization. Sexual and reproductive health. https://www.who.int/reproductivehealth/topics/infertility/en/. Accessed November 2, 2021.

A Patient’s Guide to Assisted Reproductive Technology. Society for Assisted Reproductive Technology. https://www.sart.org/patients/a-patients-guide-to-assisted-reproductive-technology. Accessed November 3, 2021.

(Rev. 7/2023)

Key: AD = atopic dermatitis; BSA = body surface area; crm = cream; JAK = Janus kinase; MACE = major adverse cardiovascular events; oint = ointment; soln = solution; UVB = ultraviolet B; TCS = topical corticosteroid

¹ Increased absorption of mid- to higher-potency TCS applied under the wraps may cause hypothalamic-pituitary-adrenal axis suppression.

² Systemic immunosuppressants (eg, methotrexate, mycophenylate mofetil, azathioprine) have been recommended for severe AD in patients with topical treatment failure.

³ See Topical Steroid Potencies chart for more drug information.

⁴ For children aged <2yrs with mild to severe disease, off-label use of tacrolimus 0.03% or pimecrolimus 1% can be recommended.

⁵ Increased risk of serious infections, all-cause mortality, malignancies, MACE, and thrombosis in patients treated with JAK inhibitors for inflammatory conditions.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

Eichenfield LF, Tom WL, Berger TG, et al. Guidelines of care for the management of atopic dermatitis. American Academy of Dermatology, Inc. Published: May 07, 2014. http://dx.doi.org/10.1016/j.jaad.2014.03.023

Fleming P, Yang YB, Lynde C, O’Neill B, Lee KO. Diagnosis and management of atopic dermatitis for primary care providers. J Am Board Fam Med. 2020; 33 (4); 626-635.

(Rev. 6/2023)

Influenza Antiviral Medications: Summary for Clinicians. Centers for Disease Control and Prevention Web site. https://www.cdc.gov/flu/professionals/antivirals/summary-clinicians.htm. Accessed January 18, 2023.

(Rev. 1/2023)

Key:+ = scored; IR = immediate-release; HCTZ = hydrochlorothiazide; SBP = systolic blood pressure

¹ Treatment of heart failure concomitant with diuretic +/- digitalis.

² Treatment of CHF in stabilized patients after MI.

³ Moderate CYP3A inhibitors include erythromycin, verapamil, saquinavir, fluconazole.

⁴ Fixed combination is not indicated for initial therapy of edema except in patients in whom the development of hypokalemia cannot be risked.

⁵ As adjunct to standard therapy for heart failure in black patients.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 9/2023)

Key: EUA = Emergency Use Authorization; IM = intramuscular

 ¹ mRNA vaccines: most systemic post-vaccination symptoms are mild to moderate in severity, occur within the first 3 days of vaccination, and resolve with 1-3 days of onset. Symptoms are more frequent and severe following 2nd dose and among younger people compared with older (eg, >55yrs/Pfizer-BioNTech, ≥65yrs/Moderna). Those with prior SARS-CoV-2 infection may be more likely to experience symptoms such as fever, chills, and myalgia after the 1st dose.

 ² Stability is for unopened vials unless otherwise specified. Frozen vaccines must be thawed and diluted before use, either in refrigerator or at room temperature, and should not be refrozen.

 ³ Nucleoside-modified mRNA encoding the viral spike (S) glycoprotein of SARS-CoV-2.

 ⁴ The Pfizer-BioNTech bivalent vaccine vials should not be stored at -25°C to -15°C/-13°F to 5°F.

 ⁵ Individuals who have received three 0.2mL doses of either monovalent or bivalent Pfizer-BioNTech COVID-19 vaccine.

 ⁶ Individuals who have received two 0.25mL doses of either monovalent or bivalent Moderna COVID-19 vaccine.

 ⁷ Engineered portion of viral spike (S) glycoprotein from SARS-CoV-2, combined with adjuvant (saponin-based Matrix-M).

 ⁸ The Novavax vaccine is under EUA as a first booster dose to adults age ≥18yrs for whom an FDA-authorized mRNA bivalent COVID-19 booster vaccine is not accessible or clinically appropriate, and to adults ≥18yrs who elect to receive the Novavax vaccine because they would otherwise not receive a booster dose of a COVID-19 vaccine.

Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers): Emergency Use Authorization (EUA) of the Novavax COVID-19 Vaccine, Adjuvanted to Prevent Coronavirus Disease 2019 (COVID-19). Accessed June 26, 2023. https://www.fda.gov/media/159897/download.

Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization of Moderna COVID-19 Vaccine, Bivalent (Original and Omicron BA.4/BA.5). Accessed June 26, 2023. https://www.fda.gov/media/167208/download.

Fact Sheet for Healthcare Providers Administering Vaccine: Emergency Use Authorization of Pfizer-BioNTech COVID-19 Vaccine, Bivalent (Original and Omicron BA.4/BA.5). Accessed June 26, 2023. https://www.fda.gov/media/167211/download.

(Rev. 6/2023)

Key: CFTR = cystic fibrosis transmembrane conductance regulator; inh = inhalation; MWF = monday, wednesday, friday; NSAIDS = Nonsteroidal anti-inflammatory drugs; pkt = packet; pwd = powder; RTI = respiratory tract infection

¹ Refer to the CF Foundation’s Pulmonary Clinical Practice Guidelines Committee for their recommendations on the use of oral antibiotics for maintenance therapy.

² The guidelines recommended the use of ibuprofen to prevent the loss of lung function in patients with FEV1 >60% predicted. The Committee updated the guidelines to limit the use of ibuprofen to only children aged 6-17yrs.

³ Take with fat-containing food (eg, eggs, butter, peanut butter, cheese pizza, whole-milk dairy products).

⁴ Mix oral granules with 1 tsp (5mL) of soft-food or liquid (eg, pureed fruits/vegetables, yogurt, applesauce, water, milk, juice, breast milk, or infant formula) and completely consume within 1hr.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

Mogayzel PJ, Naureckas ET, Robinson KA, et al. Cystic fibrosis pulmonary guidelines: chronic medications for maintenance of lung health. Am J Respir Crit Care Med. 2013 Apr 1;187(7):680-9. doi: 10.1164/rccm.201207-1160oe.

(Rev. 4/2024)

¹ Recombinant.
² For melanoma with BRAF V600E or V600K mutations.
³ For melanoma with BRAF V600 mutation only.

Not an inclusive list of medications and/or doses. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 6/2023)

¹ Contains a preservative (eg, benzalkonium chloride, polyquaternium-1, sodium perborate, sodium chlorite, Purite, etc.)

² Available with a preservative and preservative-free.

³ Remove contact lens prior to use.

⁴ Lipid nano-droplet technology for a long-lasting relief of 8hrs.

Not an inclusive list of medications and/or official indications. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 1/2023)

Key: + = scored; ER = extended-release; HD = hemodialysis; IR = intermediate-release; SL = sublingual

¹ Use lowest effective dose

² Contains tartrazine

³ Contains phenylalanine

Not an inclusive list of medications, official indications, or dosing information. Please see drug monograph at www.eMPR.com and/or contact company for full drug labeling.

(Rev. 9/2023)

Key: 5HT₃ = 5-hydroxytryptamine-3 (serotonin); AUC = area under the curve; CINV = chemotherapy induced nausea and vomiting; IV = intravenous; NK₁ = neurokinin 1; PO = oral; SC = subcutaneous

¹  For emetic risk category of chemotherapeutic agents, see “Emetogenic Potential of Antineoplastic Agent” chart.

²  Adults treated with antineoplastic combinations should receive the antiemetic regimen appropriate for the component antineoplastic agent of greatest emetic risk.

³  For adults treated with carboplatin AUC ≥4mg/mL (emetic risk is at the higher end of the moderate-emetic risk category), add NK₁ receptor antagonist for a 3-drug regimen. Dexamethasone dosing is Day 1 only: 20mg with rolapitant, and 12mg with aprepitant, fosaprepitant, or netupitant-palonosetron.

⁴  Give antiemetic regimen on the day of chemotherapy (single-day) before the dose of the antineoplastic agent. For multi-day chemotherapy, first determine the emetic risk of the agent(s) included in the regimen. Patients should receive the agent of the highest therapeutic index daily during chemotherapy and for 2 days thereafter. Granisetron transdermal patch or granisetron ext-rel inj, which deliver therapy over multiple days rather than a daily 5-HT₃ receptor antagonist, can be given.

⁵  If netupitant-palonosetron or fosnetupitant-palonosetron is used, no additional 5-HT₃ receptor antagonist is needed.

⁶  Dexamethasone dosing is for patients receiving the recommended 4-drug regimen for high-emetic risk. If NK₁ receptor antagonist was omitted, the dexamethasone dose should be adjusted to 20mg on Day 1 and 16mg on Days 2–4.

⁷  If rolapitant is used, give with dexamethasone 20mg PO or IV on Day 1, and 8mg PO or IV twice daily on Days 2–4.

⁸  For cisplatin and other high-emetic-risk single agents, dexamethasone and olanzapine should be continued on Days 2–4. For anthracycline + cyclophosphamide regimens, only continue olanzapine on Days 2–4.

⁹  If fosaprepitant is used, give with dexamethasone 8mg PO or IV on Day 2, and 8mg PO or IV twice daily on Days 3–4.

¹⁰ For moderate-emetic risk agents that are known to cause delayed nausea & vomiting (eg, cyclophosphamide, doxorubicin, oxaliplatin), may continue dexamethasone on Days 2–3.

(Rev 5/2023)