Adult CINV & RINV Receiving emetogenic chemotherapy & RT 8 mg by slow IV inj (in not less than 30 sec) or IM inj immediately before treatment, followed by 8 mg orally 12 hrly. Continue oral treatment for up to 5 days after a course of treatment to protect against delayed or prolonged emesis after the 1st 24 hr.
Receiving highly emetogenic chemotherapy Efficacy of ondansetron may be enhanced by the administration of a single IV dose of 20 mg dexamethasone Na phosphate prior to chemotherapy. Dose schedules over the 1st 24 hr of chemotherapy: Single dose of 8 mg by slow IV inj (in not less than 30 sec) or IM inj immediately before chemotherapy; or 8 mg by slow IV inj (in not less than 30 sec) or IM inj immediately before chemotherapy, followed by 2 further IV inj (in not less than 30 sec) or IM doses of 8 mg 4 hr apart, or by a constant infusion of 1 mg/hr for up to 24 hr; or max initial IV dose of 16 mg diluted in 50-100 mL of saline or other compatible infusion fluid & infused over not less than 15 min immediately before chemotherapy. Max single dose: 16 mg. Continue oral treatment for up to 5 days after a course of treatment to protect against delayed or prolonged emesis after the 1st 24 hr.
Prevention of PONV Single dose of 4 mg by IM or slow IV inj at induction of anaesth.
Treatment of established PONV Single dose of 4 mg by IM or slow IV inj.
Childn & adolescent 6 mth to 17 yr CINV Dilute in 5% dextrose or 0.9% NaCl or other compatible infusion fluid & infuse intravenously over not less than 15 min. Wt-based dosing results in higher total daily doses compared to BSA-based dosing. BSA-based dosing: Administer immediately before chemotherapy as a single IV dose of 5 mg/m
2, must not exceed 8 mg. Oral dosing can commence 12 hr later & may be continued for up to 5 days. Total dose over 24 hr (given as divided doses) must not exceed adult dose of 32 mg.
BSA >1.2 m2 5 mg/m
2 or 8 mg IV + 8 mg syr or tab after 12 hr on day 1, followed by 8 mg syr or tab every 12 hr on days 2-6,
0.6-1.2 m2 5 mg/m
2 IV + 4 mg syr or tab after 12 hr on day 1, followed by 4 mg syr or tab every 12 hr on days 2-6,
<0.6 m2 5 mg/m
2 IV + 2 mg syr after 12 hr on day 1, followed by 2 mg syr every 12 hr on days 2-6. Wt-based dosing: Administer immediately before chemotherapy as a single IV dose of 0.15 mg/kg, must not exceed 8 mg. 2 further IV doses may be given in 4 hrly intervals. Oral dosing can commence 12 hr later & may be continued for up to 5 days. Total dose over 24 hr (given as divided doses) must not exceed adult dose of 32 mg.
Weighing >10 kg Up to 3 doses of 0.15 mg/kg IV every 4 hr on day 1, followed by 4 mg syr or tab every 12 hr on days 2-6,
≤10 kg Up to 3 doses of 0.15 mg/kg IV every 4 hr on day 1, followed by 2 mg syr every 12 hr on days 2-6.
Childn & adolescent 1 mth to 17 yr Prevention of PONV Single dose of 0.1 mg/kg by slow IV inj (not less than 30 sec) up to a max of 4 mg either prior to, at or after induction of anaesth.
Treatment of PONV Single dose of 0.1 mg/kg by slow IV inj (not less than 30 sec) up to a max of 4 mg.
Elderly CINV & RINV Dilute in 50-100 mL of saline or other compatible infusion fluid & infuse intravenously over 15 min.
≥75 yr Max initial IV dose: 8 mg, may be followed by 2 further IV doses of 8 mg, infused over 15 min & given no less than 4 hr apart,
65-74 yr Follow dose schedule for adults.
Patient w/ moderate or severe hepatic impairment Max total daily dose: 8 mg.
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