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Vial $0.29, Tablet $0.06

Ondansetron

Editor: Updated Class:

ADMINISTRATION ROUTES:

PO, IV, IM

ALTERNATIVE NAMES:

Zofran

ICU INDICATIONS:

  1. Nausea and vomiting

PRESENTATION AND ADMINISTRATION:

IV:

Ondansetron 4 mg/2 mL and 8 mg/4 mL

Doses of up to 8 mg can be administered undiluted by slow IV injection over 2 to 5 minutes

Doses of 8 mg to 32 mg, which are rarely if every administered in ICU, should be diluted in 50 - 100 mL of compatible IV fluid and infused over 15 minutes or more.

Compatible with the following IV fluids: 0.9% saline, 5% dextrose, Glucose and sodium chloride, Hartmann's, 10% mannitol

Store at room temperature. Protect from light

IM:

Inject undiluted into a large muscle (not routinely used in ICU)

PO:

Tablets:

Zofran 4mg and 8 mg tablets (yellow)

Dispersible tablets:

Zofran zydis 4mg and 8mg tablets (white)

DOSAGE:

IV:

4 - 8 mg QID

PO:

4 - 8 mg QID

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

0.2 mg/kg BD - QID

CLINICAL PHARMACOLOGY:

Ondansetron is a selective 5-HT3 receptor antagonist. While ondansetron's mechanism of action has not been fully characterised, it is not a dopamine-receptor antagonist. Serotonin receptors of the 5-HT3 type are present both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone of the area postrema. It is not certain whether ondansetron's antiemetic action in chemotherapy-induced nausea and vomiting is mediated centrally, peripherally, or in both sites.

CONTRAINDICATIONS:

  1. Hypersensitivity to ondansetron

WARNINGS:

Nil

PRECAUTIONS:

General:

Nil

Laboratory Tests:

No tests additional to routine ICU tests are indicated

Drug/Laboratory Test Interactions:

None reported

IMPORTANT DRUG INTERACTIONS IN ICU:

None of note

ADVERSE REACTIONS:

Body as a Whole:

Rash, anaphylaxis

Cardiovascular:

Hypotension, tachycardia, flushing

Gastrointestinal:

Constipation, elevated transaminases

Neurological:

Headache