Ondansetron Injectable

Generic Name: Ondansetron

Brand Names:

Availability: Available with Prescription

Drug Class: Antiemetic (serotonin 5-HT 3 receptor antagonist)

Therapeutic action

  • Antiemetic (serotonin 5-HT 3 receptor antagonist)

Indications

  • Prevention of post-operative nausea and vomiting in children 
  • Treatment of post-operative nausea and vomiting

Forms and strengths, route of administration

  • 4 mg ampoule (2 mg/ml, 2 ml) for slow IV injection(3 to 5 minutes)

Dosage and duration

Prevention of post-operative nausea and vomiting

  • Child over 1 month: 0.1 mg/kg at the end of surgery(max. 4 mg per injection)

Treatment of nausea and vomiting

  • Child over 1 month:
    • No prophylactic dose of ondansetron received: 0.1 mg/kg every 8 hours if necessary 
    • Prophylactic dose of ondansetron received and late postoperative vomiting (≥ 6 hours after surgery): 0.1 mg/kg every 6 hours if necessary Do not exceed 4mg per injection and 3 injections per 24hours. 
  • Adult: 4 mg every 8 hours if necessary (max. 3 injections per 24 hours)

Contra-indications, adverse effects, precautions

  • Do not administer to children less than 1 month of age.
  • Administer with caution and monitor use in patients with congenital long QT syndrome, cardiac insufficiency and bradycardia.
  • Reduce the dose in patients with hepatic failure (max. 8 mg daily).
  • May cause: headache, sensation of flushing or warmth, hiccups, constipation, heart rhythm disorders, QT interval prolongation, extrapyramidal reactions, seizures, cutaneous allergic reactions (Lyell’s and Stevens-johnson syndromes).
  • Avoid or monitor combination with:
    • drugs that prolong the QT interval: amiodarone, bedaquilline, chloroquine, co-artemether, erythromycin, fluconazole, haloperidol, moxifloxacin, mefloquine, pentamidine, quinine, etc.; 
    • serotonergics: fluoxetine, paroxetine, tricyclic antidepressants, etc.;
    • enzyme inducers:rifampicin, rifabutin, nevirapine, ritonavir, phenobarbital, phenytoin, carbamazepine, griseofulvin, etc. (efficacy of ondansetron reduced);
    • tramadol (antalgic effect reduced).
  • Pregnancy: avoid during the first trimester; not recommended for nausea and vomiting of pregnancy
  • Breast-feeding: not recommended

Storage

– Below 25 °C