Apulset is indicated for the prevention and treatment of post-operative nausea and vomiting and for the management of nausea and vomiting induced by cytotoxic chemotherapy and nausea and vomiting associated with radiotherapy, either total body irradiation or single dose fraction or daily fractions to the abdomen. It is also used for the prevention and treatment of nausea and vomiting associated with pregnancy and gastroenteritis.
Dosage & Administration
Tablet & Oral Solution:
For adults:
Prevention of nausea & vomiting associated with chemotherapy: Highly emetogenic chemotherapy: 24 mg once 30 minutes before start of single-day chemotherapy. Moderately emetogenic chemotherapy: 8 mg every 8 hours for 2 doses beginning 30 minutes before chemotherapy, then 8 mg every 12 hours for 1-2 days after chemotherapy completed.
Prevention of nausea & vomiting associated with radiotherapy: Total body irradiation: 8 mg 1-2 hours before each fraction of radiotherapy administered each day. Single high-dose fraction radiotherapy to abdomen: 8 mg 1-2 hours before radiotherapy, then 8 mg every 8 hours after 1st dose for 1-2 days after radiation completed. Daily fractionated radiotherapy to abdomen: 8 mg 1-2 hours before radiotherapy, then 8 mg every 8 hours after 1st dose for each day of radiotherapy.
Prevention of post-operative nausea & vomiting: 16 mg 1 hour before induction of anesthesia.
For children:
Prevention of nausea & vomiting associated with highly emetogenic chemotherapy, radiotherapy, or <4 yrs of age: not recommended. Prevention of nausea & vomiting associated with moderately emetogenic chemotherapy (4-11 yrs): 4 mg every 4 hours for 3 doses beginning 30 minutes before chemotherapy, then 4 mg every 8 hours for 1-2 days after chemotherapy completed.
Injection:
For adults:
Prevention of nausea & vomiting associated with chemotherapy: Infuse over 15 minutes. 0.15 mg/kg (max 16 mg/dose) IV every 4 hours for 3 doses beginning 30 minutes before chemotherapy.
Prevention of post-operative nausea & vomiting: Infuse in not less than 30 seconds, preferably over 2-5 minutes: 4 mg IV as single dose immediately before induction of anesthesia; or shortly post-operative if nausea or vomiting occurs. Or, may use 4 mg IM undiluted as a single injection.
For children:
Prevention of nausea & vomiting associated with chemotherapy: Infuse over 15 minutes. 6 months-18 yrs: 0.15 mg/kg (max 16 mg/dose) IV for 3 doses every 4 hours beginning 30 minutes before chemotherapy.
Prevention of post-operative nausea & vomiting: Infuse in not less than 30 seconds, preferably over 2-5 minutes. 1 month-12 yrs (<40 kg): 0.1 mg/kg; 40 kg: 4 mg. Give IV as single dose immediately before induction of anesthesia; or shortly post-op if nausea or vomiting occurs.
Dosage adjustment for patients with impaired hepatic function:
The dosage recommendation is the same as for the general population. For severe hepatic dysfunction a total daily dose of 8 mg should not be exceeded.
Side effects
The most common side effects reported after taking Ondansetron may include headache, diarrhea, fatigue, constipation, dizziness, drowsiness, hypoxia, pyrexia, pruritus etc.
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