Ondansetron Sublingual Dosing for Children

Weight-Based Dosing Recommendations

• The American Society of Clinical Oncology recommends ondansetron oral disintegrating tablets (ODT) should be dosed at 0.15 mg/kg per dose (maximum 8 mg) for children, with weight-based dosing preferred for those under 40 kg 1, 2

• For children ≥12 months, the following weight-based dosing schedule is recommended:

  Weight	Dose
  ≤15 kg (≤33 lb)	30 mg twice daily
  >15-23 kg (33-51 lb)	45 mg twice daily
  >23-40 kg (>51-88 lb)	60 mg twice daily
  >40 kg (>88 lb)	75 mg twice daily (adult dose) [2]

  Formulation Options

• Oral dissolving tablets are the preferred sublingual formulation, dissolving on the tongue without water, as recommended by the Journal of Clinical Oncology 1, 2
• Standard ondansetron tablets can be used but require swallowing, according to the Journal of Clinical Oncology 1

Clinical Context and Administration

• For chemotherapy-induced nausea, the first dose of ondansetron should be given 30 minutes before emetogenic chemotherapy, with subsequent doses 8 hours later, followed by twice daily dosing for 2 days after chemotherapy completion, as suggested by Praxis Medical Insights 2

Important Caveats

• No dosage adjustment is needed based on age alone in teenagers or for renal impairment, as stated by Praxis Medical Insights 2

Safety Profile

• The oral disintegrating formulation of ondansetron eliminates concerns about IV access and is particularly useful when oral intake is difficult, as noted by the Journal of Clinical Oncology and Praxis Medical Insights 1, 2