5HT3-receptor antagonists (Formulary: CNS)

TAM (Treatments and Medicines) NHS Highland
NHS Highland

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

Guidelines:

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).

Formulation and dosage details

Formulation:

  • Ondansetron tablets 4mg, 8mg

Indications:

  • Prevention and treatment of post-operative nausea and vomiting.
  • Emetogenic chemotherapy and radiotherapy.

Formulation and dosage details

Formulation:

  • Ondansetron orodispersible tablets 4mg, 8mg

Dosage:

Indications:

  • Prevention and treatment of post-operative nausea and vomiting.
  • Emetogenic chemotherapy and radiotherapy.

Place in therapy:

  • Ondansetron orodispersible tablets are less cost-effective. They 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:

  • Ondansetron oral solution (sugar-free) 4mg/5mL

Dosage:

Indications:

  • Prevention and treatment of post-operative nausea and vomiting.
  • Emetogenic chemotherapy and radiotherapy.

Formulation and dosage details

Formulation:

  • Ondansetron injection 4mg/2mL, 8mg/4mL

Dosage:

Indications:

  • Prevention and treatment of post-operative nausea and vomiting.
  • Emetogenic chemotherapy and radiotherapy.

GRANISETRON

Therapy notes

Formulation and dosage details

Formulation:

  • Granistron tablets 1mg (Restriction: Specialist initiation only)

Dosage:

Indication:

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

Formulation and dosage details

Formulation:

  • Granisetron injection 3mg/3mL (Restriction: Specialist use only)

Dosage:

Indication:

  • 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 (Restriction: Specialist use only)

Indication:

  • See SMC advice 1109/15: in adults for the prevention of acute and delayed nausea and vomiting associated with highly emetogenic cisplatin-based cancer chemotherapy and moderately emetogenic cancer chemotherapy.
    SMC restriction: prevention of acute and delayed nausea and vomiting associated with highly emetogenic cisplatin-based cancer chemotherapy.

Editorial Information

Version: 2

Document Id: F085