What Types of Chemo Medicines Cause Nausea and Vomiting?

Some chemo medicines are more likely than others to cause nausea and vomiting. Chemo medicines are grouped according to how likely they are to cause nausea and vomiting.

The ones most likely to cause nausea and vomiting are called highly emetogenic (eh-MET-oh-JEN-ic)
Other chemo medicines that are less likely to cause these effects are considered moderately emetogenic

Emesis is a medical term for vomiting. Emetogenic refers to a medicine that causes nausea and vomiting.

When some chemo medicines are given in high doses, or when they are given together, they can make chemotherapy-induced nausea and vomiting (CINV) worse.

How do I know if my chemo medicine is moderately or highly emetogenic?

Listed below are examples of highly and moderately emetogenic chemo medicines that are currently available. Additional therapies are continually being developed.

Some of these medicines may be given together according to a set schedule. You may hear this course of treatment referred to as a regimen. When certain chemo medicines are combined, they can raise the risk of nausea and vomiting.

Highly emetogenic chemotherapies
Anthracycline/cyclophosphamide combination
Carmustine
Cisplatin
Cyclophosphamide*
Dacarbazine
Hexamethylmelamine (oral)
Mechlorethamine
Procarbazine (oral)
Streptozocin
Carboplatin*
Doxorubicin*
Epirubicin*
Daunorubicin*

Moderately emetogenic chemotherapies
Bendamustine	Carboplatin*
Clofarabine	Cyclophosphamide*
Cytarabine	Daunorubicin*
Doxorubicin*	Epirubicin*
Idarubicin	Ifosfamide
Irinotecan	Oxaliplatin
Romidepsin	Thiotepa
Trabectedin	Bosutinib (oral)
Ceritinib (oral)	Crizotinib (oral)
Cyclophosphamide (oral)	Imatinib (oral)
Temozolomide (oral)	Vinorelbine (oral)
Alemtuzumab

*The level of emetogenicity may increase or decrease according to dose or administration.

Common chemo medicines used in the treatment of lung and breast cancers

Two types of cancer that affect a lot of Americans are lung cancer and breast cancer. The chemo medicines used in treatment of these cancers are usually highly emetogenic. Listed here are some common chemo medicines used for these types of cancer.

Lung Cancer	Breast Cancer
Carboplatin	Cyclophosphamide (IV and oral)
Cisplatin	Docetaxel
Docetaxel	Doxorubicin
Etoposide	Epirubicin
Gemcitabine	5-fluorouracil
Paclitaxel
Pemetrexed
Vinblastine
Vinorelbine

Ask your doctor if the chemotherapy prescribed for you is likely to cause nausea and vomiting.

Without any preventive treatments, highly emetogenic medicines cause nausea and vomiting in
MORE THAN 90% OF PATIENTS.

Without any preventive treatments, moderately emetogenic medicines cause nausea and vomiting in
30% TO 90% OF PATIENTS.

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Without any preventive treatments, highly emetogenic medicines cause nausea and vomiting in
MORE THAN 90% OF PATIENTS.

Without any preventive treatments, moderately emetogenic medicines cause nausea and vomiting in
30% TO 90% OF PATIENTS.

Approved Use/Important Safety Considerations

Approved Use

AKYNZEO® is a prescription medicine called an "antiemetic." AKYNZEO is used in combination with the medicine dexamethasone in people to help prevent the nausea and vomiting that happens right away or later with certain anti-cancer medicines (chemotherapy).

It is not known if AKYNZEO is safe and effective in children under 18 years of age.

Important Safety Considerations

AKYNZEO may cause serious side effects, including:

allergic reactions, such as anaphylaxis. Get emergency medical help right away if you get any of the following symptoms of a serious allergic reaction: hives, swollen face, trouble breathing, or chest pain.
serotonin syndrome which can happen with AKYNZEO particularly with certain other medicines such as anti-depressants and anti-migraine medicines and can lead to death. Stop taking AKYNZEO capsules and go to the nearest hospital emergency room right away if you get any of the following symptoms: agitation, hallucinations or other changes in mental status, dizziness, fast heartbeat, sweating, high body temperature, shaking (tremors), unsteady movements, muscle twitching (overactive reflexes), or seizures with or without nausea, vomiting, and diarrhea.

The most common side effects of AKYNZEO capsules and injection include: headache, weakness, fatigue, upset stomach, constipation, and skin redness.

These are not all the possible side effects of AKYNZEO. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Before you take or receive AKYNZEO, tell your doctor about all of your medical conditions, including if you:

have had an allergic reaction to palonosetron or another medicine for nausea or vomiting.
have liver problems.
have kidney problems.
are pregnant or breastfeeding or plan to become pregnant or breastfeed. AKYNZEO may harm your unborn baby. It is not known if AKYNZEO passes into breast milk and you should not take AKYNZEO if you are breastfeeding.

Tell your doctor about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. AKYNZEO and certain other medicines can affect each other, causing serious side effects.

Only take AKYNZEO as prescribed by your doctor and read the Patient Information located at the end of the Prescribing Information. You can also read the full Prescribing Information that is written for health professionals.

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