Rationale for combination antiemetic therapy and strategies for the use of ondansetron in combinations.

The identification of several safe and effective agents for the control of chemotherapy-induced nausea and vomiting has prompted an intensive effort to develop combination antiemetic regimens. The principal rationale for development of drug combinations is the potential for blocking different types of neurotransmittor receptors controlling the emetic process. Studies have shown that the combination of a neurotransmitter receptor blocker, a corticosteroid, and a benzodiazepine improves antiemetic efficacy, lessens side effects, and decreases the length of treatment and the number of drug administrations. Ondansetron appears to be an excellent antiemetic for use in combination programs because of its highly selective, 5-hydroxytryptamine (5-HT3)-blocking properties and its proven single-agent effectiveness and safety. Preliminary data show that ondansetron can be combined with dexamethasone safely with enhanced antiemetic results. Ondansetron merits further study in combination antiemetic programs.