Dolasetron Mesylate and Milk thistle

• Generic Name: dolasetron
• Dosage Forms: n.a.
• Other Brand Names: Anzemet

Prevention of nausea and vomiting associated with emetogenic cancer chemotherapy; may use orally with initial and repeat courses of moderately emetogenic chemotherapy.

In December 2010, FDA informed healthcare professionals that IV dolasetron should no longer be used to prevent nausea and vomiting associated with cancer chemotherapy in pediatric patients and adults because of the risk of prolongation of cardiac conduction intervals and development of abnormal heart rhythms. (See Cardiovascular Effects under Cautions.)

For prevention of nausea and vomiting associated with highly emetogenic chemotherapy regimens (including an anthracycline plus cyclophosphamide), ASCO recommends a 3-drug antiemetic regimen consisting of an NK1 receptor antagonist (e.g., either oral aprepitant or IV fosaprepitant), a 5-HT3 receptor antagonist (e.g., dolasetron, granisetron, ondansetron, palonosetron), and dexamethasone. ASCO states that fixed-combination netupitant and palonosetron plus dexamethasone is an additional treatment option.

For moderately emetogenic chemotherapy regimens, ASCO recommends a 2-drug antiemetic regimen preferably consisting of palonosetron and dexamethasone. If palonosetron is not available, a first-generation 5-HT3 receptor antagonist (preferably granisetron or ondansetron) may be substituted. Limited evidence suggests that aprepitant may be added to this regimen; in such cases, use of any 5-HT3 receptor antagonist is appropriate.

For chemotherapy regimens with a low emetogenic risk, ASCO recommends administration of a single dose of dexamethasone prior to chemotherapy.

For chemotherapy regimens with minimal emetogenic risk, ASCO states that routine antiemetic administration is not necessary.

Oral or IV use for prevention and treatment of postoperative nausea and vomiting.

Routine prophylaxis not recommended in patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively.

Recommended for patients who, in the clinician’s judgement, must avoid nausea and/or vomiting postoperatively, even when anticipated incidence is low.

• Generic Name: milk thistle
• Dosage Forms: n.a.
• Other Brand Names:

Milk thistle is a plant also known as Artichaut Sauvage, Cardo Lechoso, Cardui Mariae, Carduus marianus, Chardon Argenté, Chardon de Marie, Épine Blanche, Holy Thistle, Lady's Thistle, Lait de Notre-Dame, Legalon, Marian Thistle, Mariendistel, Mary Thistle, Shui Fei Ji, Silibinin, Silybe de Marie, Silybum, Silymarin, and other names.

Milk thistle has been used in alternative medicine as a possibly effective aid in treating heartburn, or seasonal allergy symptoms. Milk thistle may have been combined with other plants or extracts in a specific preparation to treat these conditions.

Other uses not proven with research have included treating malaria, mushroom poisoning, spleen or gallbladder problems, menstrual problems, liver problems (such as hepatitis B or C), and other conditions.

It is not certain whether milk thistle is effective in treating any medical condition. Medicinal use of this product has not been approved by the FDA. Milk thistle should not be used in place of medication prescribed for you by your doctor.

Milk thistle is often sold as an herbal supplement. There are no regulated manufacturing standards in place for many herbal compounds and some marketed supplements have been found to be contaminated with toxic metals or other drugs. Herbal/health supplements should be purchased from a reliable source to minimize the risk of contamination.

Milk thistle may also be used for purposes not listed in this product guide.