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Ondansetron

Classification

Antiemetic

Indications

PCP: First line for relief of undifferentiated moderate to severe nausea and vomiting

PCP: Second Line for Severe vomiting in pregnancy where dimenHYDRINATE was found to be ineffective at treating vomiting after 15-30 minutes

Contraindications

Known allergy or hypersensitivity to ondansetron
Congenital or acquired long QT syndrome
Phenylketonuria (PKU)- Ondansetron ODT may contain aspartame which should be avoided in patients with phenylketonuria. ondansetron injection can be safely administered in this population.

Adult dosages

PCP: Relief of moderate to severe undifferentiated nausea and vomiting

4 mg ODT/ IV/ IM ONCE
Oral route preferred, do not repeat dose

CCP: 4 to 8 mg PO/ SC/ IM/ IV q8h prn

Pediatric Considerations And Dosing

Follow weight-based dosing

PCP: Relief of moderate to severe nausea and vomiting

⚠️ BCEHS-specific education available
6 months to 3 years: 2mg PO/ODT ONCE
4 to 12 years: 4 mg PO/ODT ONCE
Do not repeat dose

ACP: Relief of moderate to severe nausea and vomiting

0.15mg/kg IV ONCE

Oral route preferred where possible
Do not repeat dose

Preparation and Administration

2mg oral dose for pediatrics

Give IV product orally – mix with juice to improve palatability if available

Orally dissolving tablet

Place tablet on tip of tongue
Allow tablet to dissolve and then swallow normally

Intravenous

Give undiluted over 2-5 minutes to reduce risk of side effects such as QT prolongation

Intramuscular

Inject indiluted

How Supplied

4mg ODT Tablet
4mg/2mL ampules

Mechanism Of Action

Selectively inhibits type 3 serotonergic receptors, suppressing nausea.

Pharmacokinetics

ODT

Onset: 1 hour
Duration: 6-8 hours

Parenteral

Onset: 15-30 minutes
Duration: 6-8 hours

Adverse Effects

Constipation
Headache
Hypersensitivity
QT prolongation and rarely Torsades de Pointes

Warning And Precautions

Caution in patient with phenylketonuria (PKU) due to aspartame