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Ondansetron: Brands, Price & Uses in Bangladesh
Established / FDA-approved uses Prevention of chemotherapy-induced nausea and vomiting (CINV) — for initial and repeat courses of highly and moderately emetogenic cancer chemotherapy.
About Ondansetron
Indications of Ondansetron
Established / FDA-approved uses
- Prevention of chemotherapy-induced nausea and vomiting (CINV) — for initial and repeat courses of highly and moderately emetogenic cancer chemotherapy.
- Prevention of radiotherapy-induced nausea and vomiting — including total body irradiation, single high-dose fractions, and daily fractionated radiotherapy to the abdomen.
- Prevention and treatment of postoperative nausea and vomiting (PONV).
Off-label / commonly used, non-approved indications
- Nausea and vomiting due to acute gastroenteritis (particularly in children), based on clinical practice guidance rather than a formal approved indication.
- Nausea and vomiting in other clinical settings (e.g. hyperemesis gravidarum) used per clinician judgment when standard first-line options are inadequate; this use requires individualized risk-benefit discussion (see Pregnancy and Lactation).
Ondansetron is not indicated for routine prevention or treatment of nausea unrelated to the above settings.
Dosage & Administration of Ondansetron
Chemotherapy-induced nausea and vomiting (CINV)
| Population | Regimen |
|---|---|
| Adults (highly emetogenic chemotherapy) | 0.15 mg/kg IV (up to 3 doses) or a single 24 mg oral dose (as three 8 mg tablets), given 30 minutes before chemotherapy |
| Adults (moderately emetogenic chemotherapy) | 8 mg orally 30 minutes before chemotherapy, then 8 mg 8 hours later; continue 8 mg twice daily for 1–2 days after chemotherapy if needed |
| Children 4–11 years | 4 mg orally three times daily (before, and 4 and 8 hours after chemotherapy) |
| Children ≥12 years | Same as adult moderately-emetogenic regimen |
| Children 6 months–18 years (IV, per approved pediatric regimen) | 0.15 mg/kg per dose IV, up to 3 doses, maximum 16 mg per single dose |
Radiotherapy-induced nausea and vomiting (adults)
8 mg orally 1–2 hours before each fraction of radiotherapy; for total body irradiation, 8 mg every 8 hours; treatment may continue for up to 5 days after completion of a course, depending on regimen.
Postoperative nausea and vomiting (PONV)
| Population | Dose |
|---|---|
| Adults (prevention) | 16 mg orally 1 hour before induction of anaesthesia, OR 4 mg IV/IM as a single dose at induction |
| Adults (treatment of established PONV) | 4 mg IV/IM as a single dose |
| Children >40 kg | 4 mg IV, single dose |
| Children ≤40 kg | 0.1 mg/kg IV, single dose |
Renal impairment
No dosage adjustment is generally required.
Hepatic impairment
In severe hepatic impairment, total daily dose should not exceed 8 mg.
See Administration for how to take each formulation, and Use in Special Populations for further detail on pediatric, elderly, renal, and hepatic dosing considerations.
Side Effects of Ondansetron
Common
- Headache
- Constipation
- Diarrhea
- Fatigue/malaise
Less common
- Dizziness
- Transient elevations in liver enzymes
- Flushing, hiccups
Rare but serious
- Hypersensitivity reactions, including anaphylaxis, angioedema, and bronchospasm
- QT interval prolongation and, rarely, torsade de pointes (see Precautions and Warnings)
- Transient visual disturbances, including temporary blindness (usually reversible)
- Extrapyramidal reactions (e.g. oculogyric crisis) without persistent sequelae
- Serious skin reactions (Stevens-Johnson syndrome, toxic epidermal necrolysis) — rare
Contraindications of Ondansetron
- Known hypersensitivity to Ondansetron or other selective 5-HT3 receptor antagonists.
- Concurrent use with apomorphine, due to the risk of profound hypotension and loss of consciousness.
Frequently Asked Questions about Ondansetron
What is Ondansetron used for?
Ondansetron is used to prevent and treat nausea and vomiting caused by cancer chemotherapy, radiotherapy, and surgery. It is sometimes used off-label for other causes of nausea, such as gastroenteritis, based on clinical judgment.
Can I take Ondansetron during pregnancy?
Ondansetron should only be used in pregnancy if clearly needed, since some studies have suggested a small increased risk of certain birth defects with first-trimester use, though this is not firmly established. Always consult your physician before using Ondansetron if you are pregnant or trying to become pregnant.
Who should not take Ondansetron?
People with a known hypersensitivity to Ondansetron or those taking apomorphine should not take Ondansetron, because this combination can cause profound hypotension and loss of consciousness.
What are the most common side effects of Ondansetron?
The most common side effects of Ondansetron are headache, constipation, diarrhea, and fatigue. Serious but rare effects include allergic reactions and changes in heart rhythm (QT prolongation), so tell your doctor about any heart conditions or medicines you take before starting Ondansetron.
Can Ondansetron be given to children?
Yes, Ondansetron is approved for prevention of chemotherapy-induced nausea and vomiting in children 6 months and older, and for postoperative nausea and vomiting in children, using age/weight-based dosing. Safety in younger infants has not been established, so a pediatrician should supervise use.
What should I do if I miss a dose or suspect an overdose of Ondansetron?
If a scheduled dose of Ondansetron is missed, take it as soon as remembered unless it is nearly time for the next dose. If an overdose of Ondansetron is suspected, seek immediate medical attention or contact a poison control center, since effects such as visual disturbance, severe constipation, or heart rhythm changes have been reported.
Disclaimer
The information provided is accurate to the best of our knowledge, but it does not replace professional medical advice. We cannot guarantee its completeness or accuracy, and the absence of specific information about a drug should not be taken as an endorsement. We are not responsible for any consequences arising from this information, so please consult a healthcare professional for any concerns or questions.