Clinical situationCommon treatment
Chemotherapy- and radiation-associated nausea and vomitingAcute: ondansetron (Zofran) 32 mg IV or 24 mg orally 30 minutes before chemotherapy and dexamethasone 4 mg
Delayed: metoclopramide (Reglan) 1 to 2 mg IV or orally every 2 to 4 hours and dexamethasone 4 mg2
Cyclic vomiting syndromeSupportive, and possible tricyclic antidepressants for adults25,26
GastroparesisSupportive, and possible gastric pacing24
Postoperative nausea and vomitingDroperidol (Inapsine*) 1.25 mg IV and dexamethasone 4 mg IV within 20 minutes of anesthesia; or ondansetron 4 mg IV during the last 20 minutes of surgery20
Pregnancy: hyperemesis gravidarumProchlorperazine 5 to 10 mg IM, chlorpromazine (Thorazine*) 10 to 25 mg orally, metoclopramide2 1 to 2 mg IV, and methylprednisolone (DepoMedrol)23
Pregnancy: morning sicknessMeclizine (Antivert) 25 to 50 mg orally and promethazine (Phenergan) 12.5 to 50 mg orally or IV, electrolyte replacement, thiamine supplementation21,22