Indications & Uses
Ondesta Oral is indicated for:
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Chemotherapy-induced nausea and vomiting, adults and pediatric patients (6 months to 18 years): 8 mg tablet or orodispersible tablet: three doses of 0.15 mg/kg, up to a maximum of 16 mg per dose. 4 mg orodispersible tablet: three doses of 0.15 mg/kg, up to a maximum of 16 mg per dose. Injection: three doses of 0.15 mg/kg, up to a maximum of 16 mg per dose, infused intravenously over 15 minutes. Radiotherapy-induced nausea and vomiting, adults: 8 mg tablet or orodispersible tablet: the first dose is 8 mg by mouth 1 to 2 hours before radiotherapy. After radiotherapy, give 8 mg by mouth every 8 hours for up to 5 days after a course of treatment. 4 mg orodispersible tablet: three doses of 0.15 mg/kg, up to a maximum of 16 mg per dose. Injection: three doses of 0.15 mg/kg, up to a maximum of 16 mg per dose, infused intravenously over 15 minutes. Postoperative nausea and vomiting, adults: 8 mg tablet or orodispersible tablet: 16 mg, given as two 8 mg tablets. 4 mg orodispersible tablet: 16 mg. Injection: 4 mg. Pediatrics (over 40 kg), injection: 4 mg. Pediatrics (40 kg), injection: 0.1 mg/kg. Chemotherapy-induced nausea and vomiting, adults, geriatric patients and children of 12 years or over (oral solution): For highly emetogenic cancer chemotherapy, give 30 ml (24 mg) of Ondansetron Oral Solution 30 minutes before the chemotherapy starts. For moderately emetogenic cancer chemotherapy, give 10 ml (8 mg) of Ondansetron Oral Solution 30 minutes before the chemotherapy starts. A further 10 ml dose should be given 8 hours after the first dose. Then give one 10 ml dose twice a day (every 12 hours) for 1 to 2 days after the chemotherapy is finished. Pediatric patients (4 to 11 years): 5 ml (4 mg) of Ondansetron Oral Solution should be taken 30 minutes before chemotherapy starts. The other 2 doses should be taken 4 and 8 hours after the first dose. After that, give 5 ml of the oral solution 3 times a day (every 8 hours) for 1 to 2 days after the chemotherapy is finished. Radiotherapy-induced nausea and vomiting, oral solution (adults, geriatric patients and children of 12 years or over): The recommended oral dose is 10 ml (8 mg) of Ondansetron Oral Solution 3 times daily. For total body irradiation, give 10 ml (8 mg) of Ondansetron Oral Solution 1 to 2 hours before each fraction of radiotherapy given each day. For single high-dose fraction radiotherapy to the abdomen, give one 10 ml dose of Ondansetron Oral Solution 1 to 2 hours before radiotherapy. Later doses follow every 8 hours after the first dose, for 1 to 2 days after radiotherapy is completed. For daily fractionated radiotherapy to the abdomen, give 10 ml (8 mg) of Ondansetron Oral Solution 1 to 2 hours before radiotherapy. Later doses follow every 8 hours after the first dose, for each day radiotherapy is given. Postoperative nausea and vomiting, oral solution (adults, geriatric patients and children of 12 years or over): Give 20 ml (16 mg) of Ondansetron Oral Solution 1 hour before induction of anesthesia. Oral soluble film: To prevent nausea and vomiting with highly emetogenic cancer chemotherapy, the adult oral dose is 24 mg, given one after another as three 8 mg films, 30 minutes before chemotherapy starts. To prevent nausea and vomiting with moderately emetogenic cancer chemotherapy: Adults and pediatric patients 12 years of age and older take one 8 mg film 30 minutes before chemotherapy, followed by an 8 mg dose 8 hours later. Then give one 8 mg film twice a day (every 12 hours) for 1 to 2 days after the chemotherapy is finished. Pediatric patients 4 through 11 years of age take one 4 mg film three times a day. The first dose goes 30 minutes before chemotherapy, with later doses 4 and 8 hours after that. Then give one 4 mg film three times a day (every 8 hours) for 1 to 2 days after the chemotherapy is finished. To prevent nausea and vomiting with radiotherapy, the adult dose is one 8 mg film three times a day. Postoperative nausea and vomiting: the adult dose is 16 mg, given one after another as two 8 mg films, 1 hour before anesthesia.
Side Effects
Frequently reported adverse events were headache, constipation and diarrhea, though most were mild or moderate in nature. In chemotherapy induced nausea and vomiting, rash occurred in approximately 1% of patients receiving Vomisal. There have also been reports of a sensation of flushing or warmth, hiccups and liver enzyme abnormalities. Rare cases of anaphylaxis, bronchospasm, tachycardia, angina (chest pain), hypokalemia and shortness of breath have also been reported; apart from bronchospasm and anaphylaxis, their relationship to Vomisal is unclear. There is no evidence of extrapyramidal reactions, though in rare cases oculogyric crisis has appeared alone, as well as with other dystonic reactions, without definitive clinical evidence. In PONV, with the exception of headache, rates of these events were not significantly different between the Vomisal and placebo groups.
Cautions & Contraindications
Warnings & Precautions
Hypersensitivity reactions have occurred in patients who were also hypersensitive to other selective 5-HT3 receptor antagonists. Vomisal does not stimulate gastric or intestinal motility, so it should not be used as a substitute for nasogastric suction. In patients recovering from abdominal surgery, or in those receiving chemotherapy who develop nausea and vomiting, Vomisal may mask an underlying progressive ileus or gastric distension.
Contraindications
Ondansetron should not be used by anyone who is hypersensitive to it or to any of its ingredients. It must also not be taken together with apomorphine.