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# ONDANSETRON (Zofran®) ODT/Wafer 4mg Administration

## FORMULATION

Ondansetron Orally Disintegrating Tablet (ODT) / Wafer

Strengths: 4 mg & 8 mg

## SCHEDULE

Prescription-only in Australia

Must be given under doctor direction

## INDICATIONS (Doctor Directed)

Ondansetron wafers are used for the prevention and treatment of nausea & vomiting, such as:

- Post-infusion nausea
- Medication-related nausea
- Migraine-associated nausea
- Gastro-related nausea (doctor assessed)
- Pre-IV therapy nausea prevention (common wellness clinic practice)

⚠ No TGA advertising claims for disease treatment. Use general wording: "Used under medical direction for nausea support."

## CONTRAINDICATIONS

Ondansetron ODT must NOT be given to patients with:

- Known hypersensitivity to ondansetron or 5-HT₃ antagonists
- Congenital long QT syndrome
- Concurrent apomorphine use (risk of profound hypotension)
- Severe hepatic impairment (max 8 mg/day)

### Use caution in:

- Electrolyte abnormalities (K+ or Mg2+ low)
- Patients on QT-prolonging medications
- Cardiac arrhythmias
- Pregnancy (requires doctor approval)

## DOSING PROTOCOL (Doctor Directed)

### ADULT STANDARD DOSE

- 4 mg wafer, repeat in 8 hours if needed
- **OR** 8 mg wafer, single dose

### MAXIMUM DOSE

- 24 mg per 24 hours (divided doses)
- **Hepatic impairment:** max 8 mg/day

### ONSET

- 10–20 minutes
- **Peak effect:** 1 hour

## ADVERSE EFFECTS

### Common

- Headache
- Fatigue
- Constipation
- Dizziness
- Mild flushing

### Less Common

- QT prolongation
- Palpitations
- Hiccups
- Elevated liver enzymes (rare)

### Emergency Red Flags (Stop + escalate)

- Chest pain
- Severe dizziness
- Syncope
- Irregular heartbeat
- Anaphylaxis (extremely rare)

## EMERGENCY PROCEDURE

If concerning symptoms occur:

1. Stop medication administration
2. Sit or lay patient flat
3. Recheck vitals
4. Apply oxygen if required
5. Inform supervising doctor
6. If deterioration → call ambulance
7. Document thoroughly

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