Zofran ODT from MicroMedex
Adult Dosing

(orally disintegrating tablets) ondansetron tablets, oral disintegrating
tablets, and solution are bioequivalent; the dosages are interchangable for
tablets, orally disintegrating tablets, and oral solution [1]

Chemotherapy-induced nausea and vomiting, Highly emetogenic
chemotherapy; Prophylaxis: 24 mg dissolved ORALLY on tongue 30 min prior
to the start of a single-day chemotherapy [2][1]

Chemotherapy-induced nausea and vomiting, Moderately emetogenic
chemotherapy; Prophylaxis: 8 mg dissolved ORALLY on tongue 30 min prior to
chemotherapy and repeated in 8 hr, then 8 mg every 12 hr for 1 to 2 days post
chemotherapy [2][1]

Postoperative nausea and vomiting; Prophylaxis: 16 mg dissolved
ORALLY on the tongue 1 hr before anesthesia induction [1][2]

Radiation-induced nausea and vomiting; Prophylaxis: (daily fractionated
radiotherapy to abdomen) 8 mg dissolved ORALLY on tongue 1 to 2 hr prior to
radiotherapy and every 8 hr after first dose for each day radiotherapy is given
[2][1]

Radiation-induced nausea and vomiting; Prophylaxis: (single high-dose
fraction radiotherapy to abdomen) 8 mg dissolved ORALLY on tongue 1 to 2 hr
prior to radiotherapy and every 8 hr after first dose for 1 to 2 days after
radiotherapy completion [2][1]

Radiation-induced nausea and vomiting; Prophylaxis: (total body
irradiation radiotherapy) 8 mg dissolved ORALLY on tongue 3 times daily given
1 to 2 hr prior to each fraction of radiotherapy administered each day [2][1]
Dose Adjustments

renal impairment: dose adjustments are not necessary; there is no
experience beyond the first day of administration [2][1]

hepatic impairment, severe: (Child-Pugh score 10 or greater); do not
exceed 8 mg/day [2][1]

geriatric patients, 65 years of age or older: dose adjustments are not
necessary [2][1]
Contraindications

concomitant use of apomorphine (Apokyn)

hypersensitivity to ondansetron [2][1]
Precautions

chemotherapy-induced nausea and vomiting; symptoms of progressive
ileus and/or gastric distension may be masked [2][1]

congenital long QT syndrome; avoid use [5]
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cross-sensitivity among selective 5-HT3 receptor antagonists has
occurred [2][1]
do not use instead of nasogastric suction; does not stimulate gastric or
intestinal peristalsis [2][1]
ECG changes, including QT prolongation and potentially fatal Torsade de
Pointes, have been reported; monitoring recommended in patients with
electrolyte abnormalities (eg, hypokalemia, hypomagnesemia),
bradyarrhythmias, congestive heart failure, and those taking concomitant
medications that prolong the QT interval [5]
following abdominal surgery; symptoms of progressive ileus and/or gastric
distension may be masked [2][1]
hepatic impairment, severe; dosage adjustment recommended [2]
phenylketonurics; ondansetron orally disintegrating tablets (Zofran
ODT(R)) contain phenylalanine [1]
Pregnancy Category B
Common Adverse Effects

Gastrointestinal: Constipation, Diarrhea

Hepatic: Increased liver enzymes

Neurologic: Headache

Other: Fatigue, Malaise
Serious Adverse Effects

Cardiovascular: Electrocardiogram abnormal, Prolonged QT interval,
Torsades de pointes

Immunologic: Anaphylaxis

Respiratory: Bronchospasm
Administration

(oral disintegrating tablets) with dry hands, peel back foil backing
and gently remove tablet; do not push oral disintegrating tablet through foil
backing; administer immediately on tongue and oral disintegrating tablet
dissolves in sec; swallow with saliva; liquid not required [1]

(oral soluble film) with dry hands, fold the pouch and tear along the
edge of the dotted line; remove film and place immediately on tongue; film
dissolves in 4 to 20 sec; swallow with saliva; liquid not required; when more
than one film is needed to make the total dose (16-mg or 24-mg dose), allow
each oral soluble film to completely dissolve prior to taking the next film [2]