Walter Collins

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  • in reply to: Maximum daily dose of Ondansetron #49128

    Walter Collins
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    From Micromedex

    Important Note
    The single 32-mg IV dose is no longer an approved dose because of the risk of QT-interval prolongation and torsades de pointes. Maximum single IV dose is 16 mg

    General Dosage Information
    Ondansetron hydrochloride tablets and oral solution are bioequivalent and interchangeable

    Chemotherapy-induced nausea and vomiting, Initial and repeat courses of highly emetogenic chemotherapy; Prophylaxis
    0.15 mg/kg IV starting 30 minutes prior to chemotherapy, repeat 4 and 8 hours after the first dose; MAX single IV dose 16 mg
    24 mg orally 30 minutes prior to chemotherapy

    Chemotherapy-induced nausea and vomiting, Initial and repeat courses of moderately emetogenic chemotherapy; Prophylaxis
    0.15 mg/kg IV infusion over 15 minutes starting 30 minutes prior to chemotherapy, repeat 4 and 8 hours after the first dose; MAX single IV dose 16 mg
    8 mg orally 30 minutes prior to chemotherapy and repeat in 8 hours, then 8 mg every 12 hours for 1 to 2 days postchemotherapy

    Drug-induced nausea and vomiting
    8 mg OR 16 mg IV once daily (off-label dosage)

    Hyperemesis gravidarum
    10 mg IV administered over 30 minutes every 8 hours (off-label dosage)
    8 mg IV twice daily (off-label dosage)

    Injection site pain
    4 mg IV pretreatment (off-label dosage)

    Irritable bowel syndrome with diarrhea
    Initial, 4 mg orally once daily; may titrate up to 8 mg orally 3 times per day as needed (off-label dosage)

    Multiple sclerosis – Nausea
    8 mg orally twice daily (off-label dosing)

    Panic disorder
    1 to 2 mg IV twice daily (off-label dosage)

    Postoperative nausea and vomiting; Prophylaxis
    4 mg IV/IM undiluted immediately prior to anesthesia induction or postoperatively; a second dose does not provide additional benefit
    16 mg orally 1 hour before anesthesia induction

    Pruritus
    (Cholestatic itching) 8 mg orally once daily for first day and twice daily for 6 additional days (off-label dosage)
    (Palmoplantar pruritus) 8 mg orally once daily. May reduce to once weekly (off-label dosage; Downs et al 1998).
    (Morphine-induced) 4 mg IV or orally given once (off-label dosage)

    Radiation-induced nausea and vomiting; Prophylaxis
    Single high-dose fraction or daily fractionated radiotherapy to abdomen: 8 mg orally 1 to 2 hours prior to radiotherapy and every 8 hours after first dose for 1 to 2 days.
    Total body irradiation radiotherapy: 8 mg orally 1 to 2 hours prior to each fraction of radiotherapy.

    Schizophrenia, Refractory; Adjunct
    4 to 8 mg orally once daily as an adjunct treatment (off-label dosage)

    Shivering, Postanesthesia; Prophylaxis
    4 mg or 8 mg IV once, usually before induction of anesthesia (off-label dosage)

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Walter Collins
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