For prevention / mitigation of nausea and vomiting:
think “AND” not “OR”
throw the kitchen sink at it ahead of time and keep it up.
ask for multiple CLASSES of agents, they act on different pathways
each “class” of anti-nausea agents hits a different chemical signaling system in your brain and body, and they have a multiplicative effect
Here are my notes on the classes and examples of each class of anti-nausea agents:
| class of drug | Names you may hear | comments |
| Dopamine agonists: D2 central and peripheral (gut) | metoclopramide: reglanprochlorperazine: compro | |
| serotonin antagonists5HT-3“setrons” | onadestron: zofrangranisetron: sustol: palonosetron: aloxitropisetron | vagus N nucleus, area postrema of brainstem |
| neurokinin antagonistsNK-1 antagonist | aprepitant: Emendrolapitant: Varubi: fosaprepitant: injection netupitant (with palonosetron) | |
| antihistamine: H1 antagonist | promethazine: phenargen | sleepiness |
| corticosteroids | dexamethasone | If T2 diabetes, plan with doc |
| benzodiazepinesGABA antagonists | lorazepam | |
| cannabinoids CB1 receptor agonist | THC, CBD | No good if required to drug test for your job |
https://en.wikipedia.org/wiki/5-HT3_antagonist
“setrons” are gold standard for cancer chemo induced nausea and vomiting (N&V) control
In the United States, the combination drug netupitant/palonosetron (trade name Akynzeo) for chemo n & v
preliminary suggestions:
1- for prevention of nausea and vomiting
-keep this up from night before chemo infusion to a few days after
night time:
5 mg of THC by mouth (can double to 10 mg)
morning:
5 mg of THC by mouth (can double to 10 mg)
25-50 mg of CBD by mouth (2-3 of the capsules you already have)
2- rescue if vomiting
-oral THC rescue:
5 mg of THC liquid in your cheek, hold as long as you can
give oral THC a good 1-1.5 hours fully to kick in
OR
-1 to 2 puffs of THC vape (don’t stress on it, breathe in and out, suck in a little air too)
give vaped THC 30 minutes fully to kick in
THC side effect mitigation
-most people need a little CBD to cut the side effects of THC taken during the day (side effects like buzz, tiredness, unsteady walking etc)
-a good place to start is roughly 3 units of CBD : 1 unit of THC
eg : 3 puffs of CBD vape : 1 puff of CBD vape
eg: 15 mg of CBD by mouth : 5 mg of THC by mouth
KEEP A DIARY
-keep a diary of ( day, time, thc, cbd, effect, side effect, comments )
your diary is your guide
after a few days you will be able to tune it to your own individual body’s needs
-we EXPECT to change the THC-CBD that you take, depending on how your body reacts
Cancer Sherpa 