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:
- Stop medication administration
- Sit or lay patient flat
- Recheck vitals
- Apply oxygen if required
- Inform supervising doctor
- If deterioration → call ambulance
- Document thoroughly