A medicine for nausea and vomiting of unknown etiology in patients with advanced cancer?

Among patients with advanced cancer, effective treatments for nausea and vomiting of unclear etiology are limited. In a trial of 30 patients with advanced cancer and persistent nausea and vomiting unrelated to chemotherapy or radiation therapy, olanzapine 5 mg daily for seven days was well tolerated and resulted in a substantial reduction in nausea scores when compared with placebo. Although larger trials are preferred to demonstrate benefit and safety, olanzapine is a reasonable option for treatment of patients with advanced cancer and persistent nausea and vomiting without obvious cause. (See: Assessment and management of nausea and vomiting in palliative care”, section on ‘No obvious cause).

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