Indications for: SUSTOL

In combination with other antiemetics, to prevent acute and delayed nausea/vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy (MEC) or anthracycline and cyclophosphamide (AC) combination regimens.

Adult Dosage:

Give as a slow, SC inj over 20–30secs with IV dexamethasone ≥30mins before chemotherapy. ≥18yrs: 10mg on Day 1 of chemotherapy; give no sooner than once every 7 days. For MEC: use IV dexamethasone 8mg on Day 1. For AC: use IV dexamethasone 20mg on Day 1, then 8mg orally twice daily on Days 2–4. If concomitant NK1 receptor antagonist: see full labeling. Renal impairment (CrCl 30–59mL/min): give Sustol on Day 1 of chemotherapy and no sooner than once every 14 days; (CrCl <30mL/min): avoid.

Children Dosage:

<18yrs: not established.

SUSTOL Contraindications:

Hypersensitivity to other 5-HT3 receptor antagonists.

SUSTOL Warnings/Precautions:

Monitor for inj site reactions (including infections, bruising/hematoma, bleeding, others); if ongoing or unresolved reactions, administer in unaffected areas. Abdominal surgery. May mask progressive ileus and/or gastric distention. GI obstruction. Monitor for constipation, decreased bowel activity. Monitor for serotonin syndrome; discontinue if symptoms occur. Renal impairment. Pregnancy. Nursing mothers.

SUSTOL Classification:

Selective 5-HT3 receptor antagonist.

SUSTOL Interactions:

Increased risk of severe bruising and/or hematoma with concomitant antiplatelets or anticoagulants. Increased risk of serotonin syndrome with concomitant other SSRIs, SNRIs, MAOIs, mirtazapine, fentanyl, lithium, tramadol, or IV methylene blue.

Adverse Reactions:

Inj site reactions, constipation, fatigue, headache, diarrhea, abdominal pain, insomnia, dyspepsia, dizziness, asthenia, gastroesophageal reflux; hypersensitivity, serotonin syndrome.


  • Hepatic (CYP1A1, CYP3A4).

Drug Elimination:

  • Renal (49%), fecal (34%). Half-life: ~24 hours.

Generic Drug Availability:


How Supplied: