ondansetron

Pronunciation

Generic Name: ondansetron (injection) (on DAN se tron)
Brand Name: Zofran

What is ondansetron?

Ondansetron blocks the actions of chemicals in the body that can trigger nausea and vomiting.

Ondansetron is used to prevent nausea and vomiting that may be caused by surgery or by medicine to treat cancer (chemotherapy).

Ondansetron injection is not for preventing nausea or vomiting that is caused by factors other than chemotherapy or surgery.

Ondansetron may be used for purposes not listed in this medication guide.

What is the most important information I should know about ondansetron?

You should not use ondansetron if you are also using apomorphine (Apokyn).

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What should I discuss with my healthcare provider before receiving ondansetron?

You should not use this medicine if you are allergic to ondansetron, or if you are also using apomorphine (Apokyn).

To make sure ondansetron is safe for you, tell your doctor if you have:

  • liver disease;

  • heart disease, congestive heart failure, a heart rhythm disorder;

  • an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);

  • a personal or family history of Long QT syndrome; or

  • if you take a diuretic or "water pill."

FDA pregnancy category B. Ondansetron is not expected to harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether ondansetron passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

How is ondansetron given?

Ondansetron is injected into a vein through an IV. A healthcare provider will give you this injection.

Ondansetron is usually given just before your surgery begins, or within 2 hours after surgery.

To prevent nausea and vomiting caused by chemotherapy, ondansetron is given 30 minutes before the start of chemotherapy. A second and third dose of ondansetron are sometimes given 4 hours and 8 hours after the first dose.

What happens if I miss a dose?

Because you will receive ondansetron in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving ondansetron?

This medicine may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.

Ondansetron side effects

Get emergency medical help if you have any of these signs of an allergic reaction: rash, hives; fever, chills, difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;

  • blurred vision or temporary vision loss (lasting from only a few minutes to several hours);

  • severe constipation;

  • a light-headed feeling, like you might pass out;

  • little or no urinating; or

  • severe skin reaction--fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Common side effects may include:

  • diarrhea or constipation;

  • drowsiness;

  • fever; or

  • headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Ondansetron dosing information

Usual Adult Dose for Nausea/Vomiting -- Chemotherapy Induced:

Recommended dose: Three 0.15 mg/kg doses (up to a maximum of 16 mg per dose). The first dose is infused over 15 minutes beginning 30 minutes before the start of emetogenic chemotherapy. Subsequent doses (0.15 mg/kg up to a maximum of 16 mg per dose) are administered 4 and 8 hours after the first dose.

Alternative therapies:
Oral soluble film dosage form:
Highly emetogenic cancer chemotherapy: 24 mg given successively as three 8 mg films administered 30 minutes before the start of single-day highly emetogenic chemotherapy, including cisplatin greater than or equal to 50 mg/m2.
Moderately emetogenic cancer chemotherapy: One 8 mg soluble film given 2 times a day. The first dose should be administered 30 minutes before the start of emetogenic chemotherapy, with a subsequent dose 8 hours after the first dose.

Usual Adult Dose for Nausea/Vomiting:

Recommended dose: Three 0.15 mg/kg doses (up to a maximum of 16 mg per dose). The first dose is infused over 15 minutes beginning 30 minutes before the start of emetogenic chemotherapy. Subsequent doses (0.15 mg/kg up to a maximum of 16 mg per dose) are administered 4 and 8 hours after the first dose.

Alternative therapies:
Oral soluble film dosage form:
Highly emetogenic cancer chemotherapy: 24 mg given successively as three 8 mg films administered 30 minutes before the start of single-day highly emetogenic chemotherapy, including cisplatin greater than or equal to 50 mg/m2.
Moderately emetogenic cancer chemotherapy: One 8 mg soluble film given 2 times a day. The first dose should be administered 30 minutes before the start of emetogenic chemotherapy, with a subsequent dose 8 hours after the first dose.

Usual Adult Dose for Nausea/Vomiting -- Postoperative:

4 mg IV (undiluted) over 2 to 5 minutes, or IM, immediately before induction of anesthesia or postoperatively if nausea or vomiting occurs within 2 hours after surgery. Alternatively, 4 mg (undiluted) may be administered intramuscularly as a single injection for adults. While recommended as a fixed dose for patients weighing more than 40 kg, few patients above 80 kg have been studied. Patients who do not achieve adequate control of postoperative nausea and vomiting following a single, prophylactic, preinduction, intravenous dose of ondansetron 4 mg, administration of a second intravenous dose of 4 mg ondansetron postoperatively does not provide additional control of nausea and vomiting.

16 mg orally 1 hour before induction of anesthesia.

Oral soluble film dosage form: 16 mg given as successively as two 8 mg oral soluble films 1 hour before induction of anesthesia.

Usual Adult Dose for Nausea/Vomiting--Radiation Induced:

8 mg orally every 8 hours, give the first dose 1 to 2 hours prior to radiotherapy.

Oral soluble film dosage form:
One 8 mg soluble film given 3 times a day.
For total body irradiation: One 8 mg soluble film given 1 to 2 hours before each fraction of radiotherapy administered each day.
For single high-dose fraction radiotherapy to the abdomen: One 8 mg oral soluble film given 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for 1 to 2 days after completion of radiotherapy.
For daily fractionated radiotherapy to the abdomen: One 8 mg oral soluble film given 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for each day radiotherapy is given.

Usual Adult Dose for Pruritus:

Study (n=150) - Induced by Intrathecal Fentanyl
8 mg IV before spinal anesthesia.

Usual Adult Dose for Alcohol Dependence:

Study (n=321) - Early onset alcoholism
4 mcg/kg two times daily.

Usual Adult Dose for Postanesthetic Shivering:

Study (n=82)
8 mg IV, 3 to 5 minutes before the induction of anesthesia.

Usual Pediatric Dose for Nausea/Vomiting -- Postoperative:

Child 1 month to 12 years:
40 kg or less: 0.1 mg/kg single dose IV, administered over 2 to 5 minutes, immediately prior to or following anesthesia induction, or postoperatively if nausea and/or vomiting present shortly after surgery.

40 kg or more: 4 mg single dose IV, administered over 2 to 5 minutes, immediately prior to or following anesthesia induction, or postoperatively if nausea and/or vomiting present shortly after surgery.

Usual Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:

Child 6 months to 18 years: 0.15 mg/kg (maximum of 16 mg per dose) as an IV infusion (over 15 minutes) administered 30 minutes before the start of emetogenic therapy, then at 4 and 8 hours after the first dose, respectively.

4 to 11 years: 4 mg orally given 30 minutes before the start of emetogenic therapy, then 4 mg orally 4 and 8 hours after the first dose. Thereafter, 4 mg orally every 8 hours for 1 to 2 days after emetogenic therapy is complete.

11 years or older:: 8 mg orally 3 times daily, or 24 mg orally once daily.

Oral soluble film dosage form: Use of ondansetron oral soluble films is not indicated for treatment of nausea and vomiting associated with highly emetogenic cancer chemotherapy in pediatric patients.
For prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy: For pediatric patients 12 years of age and older, the dosage is the same as for adults. For pediatric patients 4 through 11 years of age, the dosage is one 4 mg oral soluble film given 3 times a day. The first dose should be administered 30 minutes before the start of emetogenic chemotherapy, with subsequent doses 4 and 8 hours after the first dose. One 4 mg oral soluble film should be administered 3 times a day (every 8 hours) for 1 to 2 days after completion of chemotherapy.

Usual Pediatric Dose for Gastroenteritis:

Study (n=145) - Control of emesis during the ED phase of oral rehydration:
6 months to 12 months: 1.6 mg orally every 8 hours
1 year to 3 years: 3.2 mg orally every 8 hours
4 years or older: 4 mg orally every 8 hours

Dosage was administered 15 minutes before the start of oral rehydration.

What other drugs will affect ondansetron?

There are many other medicines that can increase your risk of heart rhythm problems if you use them together with ondansetron.

Tell your doctor about all medicines you use, and those you start or stop using during your treatment with ondansetron. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed in this medication guide.

Where can I get more information?

  • Your pharmacist can provide more information about ondansetron.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 5.01. Revision Date: 2014-06-26, 11:39:19 AM.

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