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Fixed Combination Antiemetic: A Literature Review on Prevention of Chemotherapy-Induced Nausea and Vomiting Using Netupitant/Palonosetron

Rebecca A. Clark-Snow

Cheryl Vidall

Sussanne Börjeson

Patrick Jahn

chemotherapy-induced nausea and vomiting, antiemetic guidelines, NEPA
CJON 2018, 22(2), E52-E63. DOI: 10.1188/18.CJON.E52-E63

Background: Prevention of chemotherapy-induced nausea and vomiting (CINV) can be improved with guideline-consistent use of antiemetics. However, adherence to antiemetic guidelines remains often insufficient. Therefore, new strategies that improve adherence are needed.

Objectives: To review the latest antiemetic guideline recommendations and provide an update on the use of NEPA, a fixed combination antiemetic composed of the neurokinin-1 receptor antagonist (RA) netupitant and the 5-hydroxytryptamine-3 RA palonosetron (Akynzeo®).

Methods: Analysis of the literature was performed, including guidelines, published literature, congress data on NEPA, and relevant articles on CINV.

Findings: Nurses are in a unique position to promote guideline-consistent antiemetic prophylaxis and are central in the education of patients and caregivers. Thus, nurses' continuous education on antiemetic treatments is key for the prevention and management of CINV. NEPA offers a simplified antiemetic therapy with the potential to increase guideline adherence.

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