UNCONTROLLED WHEN PRINTED
Introduction
  • Anti-nauseant and anti-emetic
  • Selective 5-HT3 receptor antagonist blocking serotonin centrally in the chemoreceptor trigger zone and peripherally on Vagus nerve terminals.
  • Onset of action up to 30 minutes

Pharmacology Review

Indications
  • Moderate to severe nausea
  • Active vomiting
  • Prophylaxis for eye and spinal injuries
Contraindications
  • Paediatrics less than 2 years old
  • Hypersensitivity
Precautions / Notes
  • Oral wafer is the preferred method of administration for ALL patients unless actively vomiting.
  • Administer IV Ondansetron slowly over 2 minutes (neat or diluted) to prevent blurred vision and dizziness.
Management

Adults:

  • Oral wafer (preferred):
    • 4mg wafer.
    • Repeat dose after 30 minutes if required.
  • IM or slow IV:
    • 4mg in 2ml.
    • Repeat the dose after 30 minutes if required.

Paediatric:

  • Oral wafer (preferred):
WeightDose
<15kg 1/2 wafer
15 – 30kg 1 wafer
Over 30kg As per adult dose
  • IM (single dose only):
AgeDose
2 - 5 years 1mg in 0.5mL
6 - 9 years 2mg in 1mL
10 - 12 years 3mg in 1.5mL
>12 years or >40kg 4mg in 2mL
Critical Care Paramedic only
  • Slow IV
WeightDose
<40kg 0.1mg/kg
>40kg 4mg

 

Special Considerations
  • Headache
  • Malaise/fatigue
  • Drowsiness
  • Dizziness
  • Rash/allergic reaction

References
References
Presentation
  • 4mg wafer
  • 4mg in 2mL vial
Ondansetron WaferOndansetron Wafer-2

 

Ondansetron

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Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

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