What is the recommended dose of ondansetron (ODT) for a 3-year-old child weighing 17 kilograms?

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Recommended Dose of Ondansetron ODT for a 3-Year-Old Child Weighing 17 kg

The recommended dose of ondansetron ODT for a 3-year-old child weighing 17 kg is 2.55 mg (0.15 mg/kg), which can be rounded to 4 mg (one 4 mg ODT tablet). 1

Dosing Guidelines

  • For children weighing 15-23 kg, the recommended dose of ondansetron is 0.15 mg/kg or 45 mg twice daily for treatment purposes 1
  • For a 17 kg child, this calculates to 2.55 mg per dose (17 kg × 0.15 mg/kg = 2.55 mg) 1
  • Since ondansetron ODT typically comes in 4 mg and 8 mg tablets, the practical dose would be one 4 mg ODT tablet 2

Administration Considerations

  • Ondansetron ODT (oral dissolving tablet) is preferred over oral solution in children with vomiting, as it has been shown to cause less early vomiting (2.7% vs 9.5%) 3
  • The tablet should be placed on the tongue where it will dissolve rapidly without requiring water 2
  • No dosage adjustment is needed based on frequency of administration for acute conditions 4

Clinical Efficacy

  • A single oral dose of ondansetron has been shown to reduce the risk of recurrent vomiting, need for IV fluids, and hospital admissions in children with acute gastroenteritis 5
  • Research shows that within the dose range of 0.13-0.26 mg/kg, higher doses of ondansetron were not superior to lower doses, nor were they associated with increased side effects 4
  • In primary care settings, ondansetron decreased the proportion of children who continued vomiting within 4 hours from 42.9% to 19.5% 6

Important Considerations

  • Monitor for potential side effects, which may include headache, constipation, and diarrhea 2
  • Ondansetron is generally well tolerated in children and rarely requires treatment withdrawal 2
  • For antiemetic purposes in children, ondansetron has demonstrated superior efficacy compared to other antiemetics like metoclopramide 2

Practical Recommendation

  • For this 3-year-old 17 kg child, administer one 4 mg ondansetron ODT tablet as a single dose 1
  • If vomiting persists, the dose may be repeated every 8 hours as needed 1
  • The ODT formulation is preferable as it dissolves on the tongue and doesn't require water, making it more suitable for a child with potential nausea or vomiting 3

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Antiemetic Drug Use in Children: What the Clinician Needs to Know.

Journal of pediatric gastroenterology and nutrition, 2019

Research

Oral ondansetron for paediatric gastroenteritis in primary care: a randomised controlled trial.

The British journal of general practice : the journal of the Royal College of General Practitioners, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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