Indications for: Ondansetron Injection
Prevention of nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including high-dose cisplatin. Prevention of post-op nausea and vomiting.
Chemotherapy (vials must be diluted; see full labeling): >18yrs: Infuse over 15 mins. 0.15mg/kg (max 16mg/dose) IV every 4hrs for 3 doses beginning 30 mins before chemotherapy. Severe hepatic dysfunction: max 8mg/day. Post-op (do not dilute): Infuse in not less than 30 seconds, preferably over 2–5 mins: 4mg IV as single dose immediately before induction of anesthesia; or shortly post-op if nausea or vomiting occurs. Or, may use 4mg IM undiluted as a single injection.
Chemotherapy (vials must be diluted; see full labeling): Infuse over 15 mins. <6 months: see full labeling. 6 months–18yrs: 0.15mg/kg (max 16mg/dose) IV for 3 doses every 4hrs beginning 30 mins before chemotherapy. Post-op (do not dilute): Infuse in not less than 30 seconds, preferably over 2–5 mins: <1 month: see full labeling. 1 month–12yrs (<40kg): 0.1mg/kg. ≥40kg: 4mg. Give IV as single dose immediately before induction of anesthesia; or shortly post-op if nausea or vomiting occurs.
Ondansetron Injection Contraindications:
Ondansetron Injection Warnings/Precautions:
<4 months of age (monitor closely). Not a substitute for nasogastric suction in gastric or intestinal peristalsis. Congenital long QT syndrome: avoid. Electrolyte abnormalities, CHF, bradyarrhythmias, concomitant drugs that prolong QT: monitor ECG. May mask progressive ileus and/or gastric distention. GI obstruction risk: monitor for decreased bowel activity. Coronary artery spasm. Monitor for myocardial ischemia during and after administration (esp. IV use; do not exceed recommended infusion rate). Phenylketonuria (ODT form). Hepatic dysfunction. Pregnancy. Nursing mothers.
Ondansetron Injection Classification:
Selective 5-HT3 receptor antagonist.
Ondansetron Injection Interactions:
See Contraindications. Profound hypotension, loss of consciousness with apomorphine. Serotonin syndrome possible esp. with concomitant serotonergic drugs (eg, SSRIs, SNRIs, MAOIs, mirtazapine, fentanyl, lithium, tramadol, IV methylene blue). May antagonize tramadol.
Diarrhea, headache, fever, constipation, fatigue, transient blindness; serotonin syndrome (discontinue if occurs); rare: angina, bronchospasm, anaphylaxis, seizures, ECG changes (including QT prolongation).
Generic Drug Availability:
Tabs 4mg, 8mg—30; ODT 4mg, 8mg—30; Oral soln—50mL, vials—contact supplier