- Approval Id
- d70f8492259f4e5d
- Drug Name
- ONDANSETRON HEXAL 2MG/ML INJECTION
- Product Name
- ONDANSETRON HEXAL 2MG/ML INJECTION
- Approval Number
- SIN13361P
- Approval Date
- 2007-10-02
- Registrant
- SANDOZ SINGAPORE PTE. LTD.
- Licence Holder
- SANDOZ SINGAPORE PTE. LTD.
- Drug Type
- Therapeutic
- Forensic Classification
- PRESCRIPTION ONLY MEDICINES
- Dosage Form
- INJECTION, SOLUTION
- Dosage
- <p><strong>4.2 Posology and method of administration</strong><br>
<u><strong>Chemotherapy and Radiotherapy Induced Nausea and Vomiting (CINV and RINV)</strong></u><br>
The emetogenic potential of cancer treatment varies according to the doses and combinations of chemotherapy and radiotherapy regimens used.<br>
The selection of dose regimen should be determined by the severity of the emetogenic challenge.</p>
<p><u>CINV and RINV in Adults</u><br>
The recommended intravenous (IV) or intramuscular (IM) dose of Ondansetron Hexal lnjection is 8 mg administered immediately before treatment.</p>
<p>For highly emetogenic chemotherapy, a maximum initial ondansetron dose of 16 mg IV infused over 15 minutes may be used. A single IV dose greater than 16 mg should not be given due to dose-dependent increase of QT prolongation risk (see sections 4.4, 4.8 and 5.1 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p>The efficacy of ondansetron in highly emetogenic chemotherapy may be enhanced by the addition of a single IV dose of dexamethasone sodium phosphate 20 mg, administered prior to chemotherapy.</p>
<p>IV doses greater than 8 mg and up to a maximum of 16 mg must be diluted in 50 mL to 100 mL of 0.9% Sodium Chloride Injection or 5% Dextrose Injection before administration and infused over not less than 15 minutes (see section 6.6 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). Ondansetron doses of 8 mg or less, do not need to be diluted and may be administered as a slow IM or IV injection in <u>not less than</u> 30 seconds.</p>
<p>The initial dose of ondansetron may be followed by 2 additional IV or IM doses of 8 mg by 2 to 4 hours apart, or by a constant infusion of 1 mg/h for up to 24 hours.</p>
<p>Oral treatment of ondansetron is recommended to protect against delayed or prolonged emesis after the first 24 hours.</p>
<p><u>CINV in Children and Adolescents (aged 2 years and over)</u><br>
In children with a body surface area of 0.6 to 1.2 m<sup>2</sup>, ondansetron is administered as a single intravenous (IV) dose of 5 mg/m<sup>2</sup> immediately before chemotherapy, followed by 4 mg orally twelve hours later. 4 mg orally twice daily can be continued for up to 5 days after a course of treatment.</p>
<p><u>CINV and RINV in Elderly</u><br>
In patients 65 to 74 years of age, the initial IV dose of ondansetron 8 mg or 16 mg, infused over 15 minutes, may be followed by 2 doses of 8 mg infused over 15 minutes and given no less than 4 hours apart. All IV doses should be diluted in 50–100 mL of saline or other compatible infusion fluid and infused over 15 minutes.</p>
<p>In patients 75 years of age or older, the initial IV dose of ondansetron should not exceed 8 mg infused over 15 minutes. The initial dose of 8 mg may be followed by 2 doses of 8 mg, infused over 15 minutes and given no less than 4 hours apart (see section 5.2 – Special Patient Populations, Elderly – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>). All IV doses should be diluted in 50–100 mL of saline or other compatible infusion fluid and infused over 15 minutes.</p>
<p><u><strong>Post-Operative Nausea and Vomiting (PONV)</strong></u><br>
<u>PONV in Adults</u><br>
For prevention of post-operative nausea and vomiting, the recommended dose of ondansetron injection is a single dose of 4 mg by intramuscular (IM) or slow intravenous (IV) injection administered at the induction of anaesthesia.</p>
<p>For treatment of established post-operative nausea and vomiting a single dose of 4 mg given by IM or slow IV injection is recommended.</p>
<p><u>PONV in Children and Adolescents (aged 2 years and over)</u><br>
For prevention and treatment of PONV in paediatric patients having surgery performed under general anaesthesia, ondansetron may be administered by slow IV injection (not less than 30 seconds) at a dose of 0.1 mg/kg up to a maximum of 4 mg either prior to, at or after induction of anaesthesia, or after surgery.</p>
<p>There is limited data on the use of ondansetron in the prevention and treatment of PONV in children under 2 years of age.</p>
<p><u>PONV in Elderly</u><br>
There is limited experience in the use of ondansetron in the prevention and treatment of post-operative nausea and vomiting in the elderly, however ondansetron is well tolerated in patients over 65 years receiving chemotherapy.</p>
<p><u><strong>Special populations</strong></u><br>
<u>Renal Impairment</u><br>
No alteration of daily dose or frequency of dosing, or route of administration are required.</p>
<p><u>Hepatic Impairment</u><br>
Clearance of ondansetron is significantly reduced and serum half-life significantly prolonged in subjects with moderate or severe impairment of hepatic function. In such patients, a total daily dose of 8 mg IV or oral should not be exceeded.</p>
<p><u>Patients with Poor Sparteine/Debrisoquine Metabolism</u><br>
The elimination half-life of ondansetron is not altered in subjects classified as poor metabolisers of sparteine and debrisoquine.<br>
Consequently, in such patients, repeat dosing will give drug exposure levels no different from those of the general population. No alteration of daily dose or frequency of dosing are required.</p>
- Route Of Administration
- INTRAVENOUS
- Indication Info
- <p><strong>4.1 Therapeutic indications</strong><br>
<strong>Adults</strong><br>
<em><strong>Injection</strong></em><br>
Ondansetron Hexal is indicated in the management of nausea and vomiting induced by cytotoxic chemotherapy and radiotherapy.</p>
<p>Ondansetron Hexal is also indicated for the prevention and treatment of post-operative nausea and vomiting.</p>
<p><strong>Paediatric Population</strong><br>
<em><strong>Injection and oral formulations</strong></em><br>
Ondansetron is indicated for the management of nausea and vomiting induced by cytotoxic chemotherapy.</p>
<p>No studies have been conducted on the use of orally administered ondansetron in the prevention or treatment of post-operative nausea and vomiting; IV injection is recommended for this purpose.</p>
- Contraindications
- <p><strong>4.3 Contraindications</strong><br>
Based on reports of profound hypotension and loss of consciousness when ondansetron was administered with apomorphine hydrochloride, concomitant use with apomorphine is contraindicated (see section 4.5 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p>Hypersensitivity to any component of the preparation (see sections 4.4 and 4.8 – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
- Atc Code
- A04AA01
- Atc Item Name
- ondansetron
- Pharma Manufacturer Name
- NOVARTIS (SINGAPORE) PTE LTD