ondansetron

Adult Dosing .

Dosage forms:  TAB: 4 mg, 8 mg, 16 mg, 24 mg; ODT: 4 mg, 8 mg; SOL: 4 mg per 5 mL; INJ (pre-filled syringe): 4 mg per 2 mL; INJ (vial): 2 mg per mL

nausea/vomiting prevention, postop

[4 mg IV/IM x1]

Alt: 16 mg PO 1h before anesthesia; Info: give IV/IM dose immed. before anesthesia or shortly postop; do not cut/chew ODT form

nausea/vomiting prevention, chemo-related

[IV route, highly-emetogenic parenteral chemo]

Dose: 8-16 mg IV x1 on day 1; Start: 30min before chemo; Max: 16 mg/dose; Alt: 0.15 mg/kg/dose IV x1 on day 1; Info: part of multi-drug regimen; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool

[IV route, moderately-emetogenic parenteral chemo]

Dose: 8-16 mg IV x1 on day 1, then may give 8-16 mg IV qd on days 2-3; Start: 30min before chemo; Max: 16 mg/dose; Alt: 0.15 mg/kg/dose IV x1 on day 1; Info: part of multi-drug regimen; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool

[PO route, highly-emetogenic parenteral chemo]

Dose: 16-24 mg PO x1 on day 1; Start: 30min before chemo; Info: part of multi-drug regimen; do not cut/chew ODT form; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool

[PO route, moderately-emetogenic parenteral chemo]

Dose: 16-24 mg PO x1 on day 1, then may give 16 mg/day PO divided qd-bid on days 2-3; Start: 30min before chemo; Alt: 8 mg PO q8h x2 doses, then 8 mg PO q12h until 1-2 days after chemo complete; Info: part of multi-drug regimen; do not cut/chew ODT form; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool

[PO route, low-emetogenic parenteral chemo (off-label)]

Dose: 8-16 mg PO x1; Start: 30min before chemo; Info: may repeat 8-16 mg PO qd for multi-day chemo; do not cut/chew ODT form; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool

[PO route, oral chemo (off-label)]

Dose: 8-16 mg PO qd; Start: 30min before chemo; Info: may give prn if minimally- or low-emetogenic oral chemo; do not cut/chew ODT form; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool

nausea/vomiting prevention, XRT-related

[total body XRT]

Dose: 8 mg PO bid-tid; Start: 1-2h before each fraction of XRT; Info: give w/ or w/o dexamethasone; do not cut/chew ODT form

[single high-dose fraction abdominal XRT]

Dose: 8 mg PO bid until 1-2 days after XRT complete; Start: 1-2h before XRT; Info: give w/ or w/o dexamethasone; do not cut/chew ODT form

[daily fractionated abdominal XRT]

Dose: 8 mg PO bid; Start: 1-2h before each fraction of XRT; Info: give w/ or w/o dexamethasone; do not cut/chew ODT form

refractory nausea/vomiting, chemo-related (off-label)

[8 mg PO/IV q8-12h]

Info: do not cut/chew ODT form; search 'CINV' for epocrates Chemo-Induced Nausea & Vomiting in Adults decision tool

nausea/vomiting, gastroenteritis-related (off-label)

[8 mg PO/IV q8h prn]

Info: do not cut/chew ODT form

cyclic vomiting syndrome, acute (off-label)

[8 mg PO/IV q4-6h prn]

Info: do not cut/chew ODT form

renal dosing

[no adjustment]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

hepatic dosing

[adjust dose amount]

Child-Pugh Class C: max 8 mg/24h

Peds Dosing .

Dosage forms:  TAB: 4 mg, 8 mg; ODT: 4 mg, 8 mg; SOL: 4 mg per 5 mL; INJ: various

nausea/vomiting prevention, chemo-related

[IV route, highly- or moderately-emetogenic chemo, 6 mo and older]

Dose: 0.15 mg/kg/dose IV q4h x3 doses; Start: 30min before chemo; Max: 16 mg/dose

[PO route, moderately-emetogenic chemo, 4-11 yo]

Dose: 4 mg PO q4h x3 doses, then 4 mg PO q8h until 1-2 days after chemo complete; Start: 30min before chemo; Info: do not cut/chew ODT form

[PO route, moderately-emetogenic chemo, 12 yo and older]

Dose: 8 mg PO q8h x2 doses, then 8 mg PO q12h until 1-2 days after chemo complete; Start: 30min before chemo; Info: do not cut/chew ODT form

nausea/vomiting prevention, postop

[1 mo-12 yo and <40 kg]

Dose: 0.1 mg/kg/dose IV x1; Max: 4 mg/dose; Info: give immed. before or after anesthesia induction or shortly postop

[>12 yo or >40 kg]

Dose: 4 mg IV x1; Info: give immed. before or after anesthesia induction or shortly postop

nausea/vomiting, gastroenteritis-related (off-label)

[8-15 kg]

Dose: 2 mg PO x1; Alt: 0.15 mg/kg/dose IV x1; Info: do not cut/chew ODT form

[16-30 kg]

Dose: 4 mg PO x1; Max: 4 mg/dose; Alt: 0.15 mg/kg/dose IV x1; Info: do not cut/chew ODT form

[>31 kg]

Dose: 8 mg PO x1; Max: 8 mg/dose PO; 4 mg/dose IV; Alt: 0.15 mg/kg/dose IV x1; Info: do not cut/chew ODT form

cyclic vomiting syndrome, acute (off-label)

[2 yo and older]

Dose: 0.3-0.4 mg/kg/dose IV q4-6h prn; Max: 16 mg/dose

renal dosing

[no adjustment]

renal impairment: no adjustment

HD/PD: no adjustment; no supplement

hepatic dosing

[not defined]

hepatic impairment: consider adult hepatic dosing for guidance