Zyprexa
How it works
Dopamine antagonist; extremely effective for chemotherapy-induced nausea refractory to standard antiemetics.
Gold standard for breakthrough chemo nausea (MASCC/ESMO 2023 & ASCO 2020). 5–10 mg for 3 days in HEC; consider 2.5 mg in older / sedation-sensitive patients. Sedate effect useful for sleep. Weight gain manageable with dietitian support.
Dosing
Typical doses
- 2.5–5 mg PO nocte
Schedule
- D1–D3 evening (nocte) for nausea preventioncycle_linked
Side Effects
- •Sedation, somnolence
- •Weight gain, increased appetite
- •Dizziness
- Metabolic syndrome risk (hyperglycemia, dyslipidemia)
Monitoring
- Blood glucose, lipid panel if on long-term olanzapine