5HT3-receptor antagonists (Formulary)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

5HT3-receptor antagonists increase large bowel transit time; constipation can be a problem.

ONDANSETRON

Therapy notes

MHRA advice: Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy (January 2020) (www.gov.uk).
MHRA advice: Ondansetron for intravenous use: posology in patients age 65 years or older (December 2014) (www.gov.uk).
MHRA advice: Ondansetron for intravenous use: dose-dependent QT interval prolongation (December 2014) (www.gov.uk).
MHRA advice: Ondansetron (Zofran): important new intravenous dose restriction (December 2014) (www.gov.uk).

  • In oncology, see Guidelines for the management of chemotherapy-induced nausea and vomiting in adult patients.

Formulation and dosage details

Formulation:

Tablets 4mg, 8mg

Dosage:

Prevention of post-operative nausea and vomiting, by mouth, 16mg 1 hour before anaesthesia or 8mg 1 hour before anaesthesia followed by a further 2 doses of 8mg every 8 hours.

Formulation and dosage details

Formulation:

Oral lyophilisates 4mg, 8mg

Dosage:

Prevention of post-operative nausea and vomiting, by mouth, 16mg 1 hour before anaesthesia or 8mg 1 hour before anaesthesia followed by a further 2 doses of 8mg every 8 hours.

Notes:

Oral lyophilisates are useful in primary care for the immediate treatment of nausea and vomiting; place on the tongue, allow to disperse and swallow. Change to non-dispersible formulations at the earliest opportunity.

Formulation and dosage details

Formulation:

Oral solution (sugar-free) 4mg/5mL

Dosage:

Prevention of post-operative nausea and vomiting, by mouth, 16mg 1 hour before anaesthesia or 8mg 1 hour before anaesthesia followed by a further 2 doses of 8mg every 8 hours.

Formulation and dosage details

Formulation:

Injection 4mg/2mL, 8mg/4mL

Dosage:

Treatment of post-operative nausea and vomiting, by intramuscularor slow intravenous injection, 4mg.  

GRANISETRON

Therapy notes

Formulation and dosage details

Formulation:

Tablets 1mg (s)

Dosage:

Only for nausea and vomiting induced by cytotoxic chemotherapy or radiotherapy.

Formulation and dosage details

Formulation:

Injection 3mg/3mL (s)

Dosage:

Only for nausea and vomiting induced by cytotoxic chemotherapy or radiotherapy.

PALONOSETRON WITH NETUPITANT

Therapy notes

Formulation and dosage details

Formulation:

Capsules (Akynzeo®) palonosetron 500 micrograms, netupitant 300mg (s)

Dosage:

See SMC advice 1109/15.

Editorial Information

Document Id: F085