Antiemetic Therapy

Available Formulations

Ondansetron is available in various formulations, including oral dissolving tablets, oral tablets, oral soluble films, and injectable solutions for IV administration, according to the American Society of Clinical Oncology and Praxis Medical Insights 1, 2

Cutting ondansetron tablets may disrupt the tablet's dissolution properties, lead to inaccurate dosing, and result in medication fragments or powder loss, highlighting the importance of using available formulations that eliminate the need for splitting, as recommended by the American Society of Clinical Oncology 2
For adults requiring antiemetic therapy, ondansetron should be dosed at 8 mg oral twice daily or 8 mg oral dissolving tablet twice daily, or 8 mg (or 0.15 mg/kg) IV for chemotherapy-induced nausea and vomiting, as recommended by the American Society of Clinical Oncology 3, 2
The recommended administration schedule is as follows:

Combination therapy with dexamethasone (12 mg oral or IV) and an NK1 receptor antagonist is recommended for optimal control, as suggested by the American Society of Clinical Oncology 3, 2
For highly emetogenic chemotherapy, a three-drug regimen including ondansetron, dexamethasone, and an NK1 receptor antagonist provides optimal control, as recommended by the American Society of Clinical Oncology 3, 2
Undertreatment of delayed nausea should be considered, and dosing may need to be extended beyond day 1 for highly and moderately emetogenic chemotherapy, as suggested by the National Comprehensive Cancer Network 3, 4
Ondansetron should be administered before radiation therapy on treatment days, according to the American Society of Clinical Oncology 2