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Single dose prophylaxis appears to be an excellent regimen compared to multiple day regimens independent of urgency of procedure [ 2- 6].
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Further, the NCCN suggests that a single dose of palonosetron may be effective in preventing CINV for a multiple-day regimen, although this finding is also based on limited evidence.
However, given the considerable variation in multiple-day chemotherapy regimens, a true standard of care or optimal antiemetic regimen has not been established.
However, currently there are no clear guidelines for management of CINV in patients receiving multiple-day chemotherapy regimens.
45, 46 Open-label 47– 49 and observational 50 studies have shown the efficacy of palonosetron in patients receiving various multiple-day chemotherapy regimens.
23 In multiple-day chemotherapy regimens, antiemetic prophylaxis should achieve long-lasting inhibition of the 5-HT3 receptors due to the persistence of the emetic stimulus throughout the entire chemotherapy cycle.
No standard evidence-based antiemetic treatment exists for the multiple-day chemotherapy regimen; however, the NCCN suggests dexamethasone in combination with a 5-HT3 RA in patients receiving a multiple-day MEC regimen.
Similar results were recorded in a group of 34 preschool children (aged 2.6 6.3 years) who were treated with a flexible multiple-day insulin regimen (premeal lispro plus bedtime glargine) for at least 1 year (Alemzadeh et al. 2005).
We are not aware of direct comparisons where glucosamine sulfate efficacy has been evaluated with varied dosing regimens, but there is a report describing that chondroitin sulfate in a once a day regimen offers a similar efficacy as multiple doses a day [ 47], for the same total dose.
Consecutive-day regimens involving multiple anticancer agents are widely used to treat bone and soft tissue sarcomas.
They were given 10-day regimens of Cipro last week.
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