Ondan
Generic Name
Ondansetron 4 mg Oral Solution
Manufacturer
Square Pharmaceuticals Ltd.
Country
Bangladesh
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| ondan 4 mg oral solution | ৳ 50.00 | N/A |
Description
Overview of the medicine
Ondansetron is an antiemetic used to prevent nausea and vomiting caused by chemotherapy, radiation therapy, and surgery. It works by blocking serotonin receptors in the gut and brain. This oral solution provides a convenient dosage form, especially for pediatric and geriatric patients.
Uses & Indications
Dosage
Adults
For chemotherapy-induced nausea and vomiting: 8 mg orally 30 minutes before chemotherapy, then 8 mg every 8 hours for 1-2 days. For PONV: 16 mg orally one hour before anesthesia.
Elderly
No specific dose adjustment is generally required for elderly patients, but monitor for QT prolongation.
Renal_impairment
No dose adjustment necessary for patients with impaired renal function.
How to Take
Administer orally, usually 30 minutes before chemotherapy or 1 hour before surgery. Can be taken with or without food. Measure the dose accurately using a measuring spoon or oral syringe.
Mechanism of Action
Ondansetron selectively blocks 5-HT3 receptors located both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone (CTZ). Serotonin (5-HT) is released from enterochromaffin cells in the gut in response to cytotoxic chemotherapy and radiation, stimulating vagal afferents and initiating the vomiting reflex. By blocking these receptors, ondansetron prevents the activation of the vomiting center.
Pharmacokinetics
Onset
30 minutes to 2 hours
Excretion
Primarily excreted in urine (approximately 5% as unchanged drug), with some excretion via feces.
Half life
Approximately 3-5 hours (adults), 2-3 hours (children), up to 20 hours (severe hepatic impairment).
Absorption
Rapidly and completely absorbed from the GI tract after oral administration, but undergoes first-pass metabolism. Bioavailability is approximately 50-60%.
Metabolism
Extensively metabolized in the liver by cytochrome P450 enzymes (CYP1A2, CYP2D6, CYP3A4) via hydroxylation, followed by glucuronide or sulfate conjugation.
Side Effects
Contraindications
- Hypersensitivity to ondansetron or any component of the formulation.
- Concomitant use with apomorphine (risk of profound hypotension and loss of consciousness).
Drug Interactions
Tramadol
May reduce the analgesic effect of tramadol.
Apomorphine
Concomitant use is contraindicated due to severe hypotension and loss of consciousness.
SSRIs/SNRIs
Increased risk of serotonin syndrome with concomitant use.
QT-prolonging drugs
Concomitant use may increase the risk of QT prolongation and Torsade de Pointes. Examples include antiarrhythmics, antipsychotics, certain antibiotics.
Phenytoin, Carbamazepine, Rifampicin
These CYP3A4 inducers may decrease ondansetron plasma concentrations.
Storage
Store at controlled room temperature (20°C to 25°C). Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Symptoms include severe constipation, transient blindness, hypotension, and vasovagal episodes with transient second-degree AV block. Management is supportive and symptomatic; there is no specific antidote.
Pregnancy & Lactation
Pregnancy: Category B. Limited human data suggest no increased risk of major birth defects. Use only if clearly needed. Lactation: Excreted into breast milk in animals. Unknown if excreted in human milk. Exercise caution when administering to a nursing mother.
Side Effects
Contraindications
- Hypersensitivity to ondansetron or any component of the formulation.
- Concomitant use with apomorphine (risk of profound hypotension and loss of consciousness).
Drug Interactions
Tramadol
May reduce the analgesic effect of tramadol.
Apomorphine
Concomitant use is contraindicated due to severe hypotension and loss of consciousness.
SSRIs/SNRIs
Increased risk of serotonin syndrome with concomitant use.
QT-prolonging drugs
Concomitant use may increase the risk of QT prolongation and Torsade de Pointes. Examples include antiarrhythmics, antipsychotics, certain antibiotics.
Phenytoin, Carbamazepine, Rifampicin
These CYP3A4 inducers may decrease ondansetron plasma concentrations.
Storage
Store at controlled room temperature (20°C to 25°C). Protect from light and moisture. Do not freeze. Keep out of reach of children.
Overdose
Symptoms include severe constipation, transient blindness, hypotension, and vasovagal episodes with transient second-degree AV block. Management is supportive and symptomatic; there is no specific antidote.
Pregnancy & Lactation
Pregnancy: Category B. Limited human data suggest no increased risk of major birth defects. Use only if clearly needed. Lactation: Excreted into breast milk in animals. Unknown if excreted in human milk. Exercise caution when administering to a nursing mother.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months, as indicated on the packaging.
Availability
Pharmacies, Hospitals
Approval Status
Approved by regulatory bodies (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical trials have demonstrated ondansetron's efficacy and safety in preventing chemotherapy-induced nausea and vomiting (CINV), radiation-induced nausea and vomiting (RINV), and postoperative nausea and vomiting (PONV). Studies have evaluated different routes of administration and dosage regimens.
Lab Monitoring
- Monitor liver function tests periodically, especially in patients with hepatic impairment.
- Monitor ECG in patients with underlying cardiac conditions, electrolyte abnormalities, or concomitant use of QT-prolonging drugs.
Doctor Notes
- Consider patient's cardiac history and concomitant medications for QT prolongation risk.
- Hepatic impairment requires careful monitoring; consider dose reduction in severe cases.
- Effective for central and peripheral emetic stimuli, but less effective for motion sickness.
Patient Guidelines
- Take as directed by your doctor.
- Do not exceed the recommended dose.
- Inform your doctor if you have liver problems, heart conditions, or are taking other medications.
- Report any unusual side effects immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and resume your regular dosing schedule. Do not double the dose.
Driving Precautions
May cause dizziness or vision disturbances. Avoid driving or operating machinery if affected.
Lifestyle Advice
- Stay hydrated, especially during chemotherapy.
- Eat small, frequent meals if experiencing nausea.
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