Usual Adult Dose for Nausea/Vomiting - Chemotherapy Induced

Recommended dose: 100 mg orally 1 hour prior to chemotherapy

Comment:

• The recommended dose should not be exceeded.

• For the prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy

Usual Adult Dose for Nausea/Vomiting - Postoperative

Recommended dose: 12.5 mg IV approximately 15 minutes before the cessation of anesthesia or as soon as nausea and vomiting presents

Comments:

• The recommended dose should not be exceeded. If a prophylactic dose fails, avoid initiating another dose as rescue therapy.
• This drug should be given as a single dose, and may be given as an IV infusion over at least 30 seconds or diluted and infused over 15 minutes.

• For the prevention of postoperative nausea and vomiting
• For the treatment of postoperative nausea and/or vomiting

Usual Pediatric Dose for Nausea/Vomiting - Postoperative

2 to 16 years:

• Recommended dose: 0.35 mg/kg IV approximately 15 minutes before the cessation of anesthesia or as soon as nausea and vomiting presents
• Maximum dose: 12.5 mg
• Alternative dose: 1.2 mg/kg (of the IV injection solution) given orally within 2 hours before surgery, up to a maximum dose of 100 mg

• The injection solution may be mixed with apple or apple-grape juice and administered orally; the mixed product may be kept up to 2 hours at room temperature before use.
• This drug should be given as a single dose, and may be given as an IV infusion over at least 30 seconds or diluted and infused over 15 minutes.

• For the prevention of postoperative nausea and vomiting
• For the treatment of postoperative nausea and/or vomiting

Usual Pediatric Dose for Nausea/Vomiting - Chemotherapy Induced

2 to 16 years:

• Recommended dose: 1.8 mg/kg orally within 1 hour before chemotherapy
• Maximum dose: 100 mg

• The recommended dose should not be exceeded.

• For the prevention of nausea and vomiting associated with initial and repeat courses of moderately emetogenic cancer chemotherapy

Renal Dose Adjustments

No adjustment recommended; however, ECG monitoring is recommended.

Liver Dose Adjustments

No adjustment recommended.

Dose Adjustments

Elderly: Dose adjustment is not required; however, ECG monitoring is recommended.

Precautions

Safety and efficacy have not been established in patients younger than 2 years.

Consult WARNINGS section for additional precautions.

Dialysis

Data not available

Other Comments

Administration advice:

• Rapid IV administration (e.g., 12.5 mg injected in less than 30 seconds) should be avoided. The IV formulation may be injected IV over 30 seconds or diluted and infused over a period of up to 15 minutes.
• Patients using this drug for postoperative nausea and vomiting prophylaxis/treatment and whose dosage requirements are lower than the tablet formulation or those unable to swallow tablets may use the IV formulation for oral administration. The oral tablet is bioequivalent to the IV solution given orally. The dose should be mixed in apple or apple-grape juice; the diluted product may be kept at room temperature and should be used within 2 hours of preparation. Use of the tablet formulation is recommended in children old enough to swallow tablets.

• The manufacturer product information should be consulted.

• The manufacturer product information should be consulted.

• The manufacturer product information should be consulted.

• Routine prophylaxis is not recommended for postoperative patients with little expectation of nausea and vomiting; however, use is recommended for patients who should avoid postoperative nausea and vomiting, even with low risk of postoperative nausea and vomiting.

• Electrolyte levels, especially in patients at risk for hypomagnesemia or hypokalemia
• ECG, especially in patients with congestive heart failure, bradycardia, renal impairment, and geriatric patients

• Inform patients that this drug may cause drowsiness, and that they should avoid driving or operating machinery until the full effects are known.
• Patients should be advised to immediately report any signs/symptoms associated with serotonin syndrome to their prescribers. Patients should also report lightheadedness, syncope episodes, or any perceived changes in heart rate.
• Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
• Tell patients to report all concurrent prescription and nonprescription medications or herbal products they are taking.