From the Guidelines
The recommended IV dose of ondansetron is 0.15 mg/kg. This dose is administered over 15 minutes, with a maximum single dose of 16 mg for adults, as stated in the American Society of Clinical Oncology clinical practice guideline update 1. For children, the recommended IV dose is not consistently specified across all guidelines, but a dose of 0.15 mg/kg is mentioned in some studies 1. Ondansetron works by selectively blocking serotonin 5-HT3 receptors in the chemoreceptor trigger zone and in the gastrointestinal tract, thereby inhibiting the vomiting reflex. Some key points to consider when administering ondansetron include:
- Administering the medication 30 minutes before chemotherapy or immediately before anesthesia induction for prevention of postoperative nausea and vomiting.
- Administering the medication on schedule rather than as needed for optimal antiemetic effect.
- Common side effects include headache, constipation, and dizziness.
- Administering the medication slowly over the recommended time to minimize potential side effects such as hypotension and dizziness that can occur with rapid administration. It's also important to note that ondansetron can be used in various clinical settings, including chemotherapy-induced nausea and vomiting, radiation therapy, and postoperative nausea and vomiting, as outlined in the guidelines 1.
From the FDA Drug Label
The recommended dosage for adult and pediatric patients 6 months of age and older for prevention of nausea and vomiting associated with emetogenic chemotherapy is 0.15-mg/kg per dose for 3 doses (maximum of 16 mg per dose).
The recommended IV dose of ondansetron per kilogram of body weight is 0.15 mg/kg.
- This dose is administered for 3 doses, with a maximum of 16 mg per dose.
- The dose is given intravenously over 15 minutes, beginning 30 minutes before the start of emetogenic chemotherapy, and then repeated 4 and 8 hours after the first dose 2.
From the Research
Ondansetron IV Dose per Kilogram of Body Weight
The recommended IV dose of ondansetron per kilogram of body weight can vary depending on the specific clinical context and patient population.
- For adults receiving cisplatin-based chemotherapy, a dose of 0.15 mg/kg IV every 4 hours for three doses has been used as standard antiemetic therapy 3.
- In pediatric patients, a dose range of 0.13-0.26 mg/kg has been studied, with no significant association between dose and efficacy or side effects within this range 4.
- For children undergoing ambulatory surgery, a dose of 100 microg/kg IV has been compared to dolasetron, with the smallest effective dose of dolasetron being 350 microg/kg IV 5.
- In another study, a single IV dose of ondansetron (32,24, or 8 mg) was used in combination with dexamethasone, with the dose of ondansetron adjusted based on the emetogenic potential of the chemotherapy regimen 6.
- A single intravenous dose of ondansetron (8-32 mg) has been shown to be effective in preventing emesis in patients receiving high-dose cisplatin chemotherapy, with the dose selected based on factors that predispose patients to emesis 7.
Key Findings
- The optimal dose of ondansetron per kilogram of body weight may vary depending on the specific clinical context and patient population.
- Doses ranging from 0.13-0.26 mg/kg have been studied in pediatric patients, with no significant association between dose and efficacy or side effects within this range 4.
- For adults receiving cisplatin-based chemotherapy, a dose of 0.15 mg/kg IV every 4 hours for three doses has been used as standard antiemetic therapy 3.