EVALUATION OF 5-HT3-RECEPTOR ANTAGONISTS IN EMETOGENIC CHEMOTHERAPY REGIMENS

The 5-HT3-receptor blockers are a relatively new class of agents that block serotonin receptors peripherally on vagal afferent nerves in the gastrointestinal tract and centrally at the chemoreceptor trigger zon e and, thus, prevent the emetic response, In this formulary evaluation , the agents were found to have similar response rates, which are comp arable with intravenous metoclopramide, Further, combination therapy w ith dexamethasone is significantly more effective than either agent al one for controlling acute nausea and vomiting. Intravenous 5-HT3-recep tor antagonists have high drug acquisition costs, however, pharmacoeco nomic data suggests these agents are more cost effective than the stan dard agents for highly emetogenic chemotherapy. Also, by replacing the IV formulation with oral 5-HT3 receptor antagonists, cost may be subs tantially decreased while maintaining good antiemetic control.