Indications for CESAMET:
Treatment of nausea and vomiting associated with cancer chemotherapy in patients who have not responded adequately to other antiemetics.
1–2mg twice daily; max 6mg/day in 3 divided doses. Give 1st dose 1–3 hours before chemotherapy is administered; use lower starting dose and increase if necessary. May give 1–2mg the night before chemo. Continue 2–3 doses/day during chemotherapy course, if needed, may continue 48 hours after each chemo cycle.
<18yrs: not recommended.
Hypertension. Heart disease. History of psychiatric disorders (eg, bipolar disorder, depression, schizophrenia) or substance abuse. Write ℞ for limited quantity (ie, enough for one chemotherapy course). Keep patient under responsible adult supervision (esp. when dose is adjusted). Renal or hepatic impairment. Elderly. Pregnancy (Cat.C). Nursing mothers: not recommended.
Potentiates CNS depression with benzodiazepines, barbiturates, alcohol, other CNS depressants and other psychoactive substances (avoid). May affect, or be affected by, other drugs that undergo first-pass hepatic metabolism or that are highly protein bound (eg, sympathomimetics, anticholinergics, tricyclic antidepressants). Cross-tolerance and mutual potentiation with opioids. Naltrexone: see literature.
Drowsiness, vertigo, dry mouth, euphoria/dysphoria, ataxia, headache, tachycardia, hypotension, concentration difficulties, sleep disturbance, other psychiatric reactions (may persist for several days after dosing), changes in appetite.