Pharmacological action Zofran 4 mg:
Antiemetic. Cytotoxic drugs for chemotherapy and radiotherapy can cause increased levels of serotonin, which by activation of vagal afferent fibers containing 5-HT3-receptor causes a gag reflex. Selectively blocks the serotonin 5-HT3-receptor neurons of the central and peripheral nervous system – the end of n.vagus in the gut and in the centers of the central nervous system (mainly the bottom of ventricular VI), governing the implementation of the gag reflex. Do not violate the coordination of movements, does not cause sedation and reduce efficiency. It possesses anxiolytic activity. Do not change the concentration of prolactin in plasma.
Uses Zofran 4 mg:
Nausea and vomiting caused by cytotoxic chemotherapy conduct or radiotherapy, postoperative nausea and vomiting – prevention and treatment.
Contraindications Zofran 4 mg:
Hypersensitivity, pregnancy, lactation. Childhood (up to 2 years – lack of experience).
Side effects Zofran 4 mg:
Allergic reactions: urticaria, bronchospasm, laryngospasm, angioedema, anaphylaxis. Local reactions: redness, pain, burning at the injection site. From the digestive system: hiccups, dry mouth, constipation or diarrhea, sometimes asymptomatic transient increase in serum aminotransferases. From the CCC: chest pain, in some cases depressed ST, fibrillation, bradycardia, decreased blood pressure. Nervous system disorders: headache, dizziness, spontaneous movement disorders and seizures. Other “surge” of blood to the face, hot flashes, a temporary disturbance of visual acuity, hypokalemia, hypercreatininemia.
Dosage and administration Zofran 4 mg:
The choice of dosage regimen is determined by the severity of the ongoing emetogennogo anticancer therapy. Adult daily dose is 8-32 mg / day, recommended regimens. With moderate emetogennogo of chemotherapy or radiotherapy – 8 mg / bolus or slow / m, just before starting therapy. With the strong expression of emetogennogo chemotherapy is administered in / jet slowly 8 mg immediately before chemotherapy, and then in / jet – to 8 mg every 2-4 hours, or in / drip continuously at a rate of 1 mg / h for 24 hours, or drip directly before the start of chemotherapy at a dose of 16-32 mg diluted in 50-100 ml of the appropriate infusion solution, for 15 minutes. Odansetron efficiency can be increased by a single on / in a corticosteroids (eg dexamethasone, 20 mg) before chemotherapy. For the prevention of delayed emesis occurring within 24 hours from the start of chemotherapy or radiotherapy – both with strong and moderate severity emetogennogo of therapy is recommended to receive the drug in tablet form. For oral administration: adults, to prevent nausea and vomiting for chemotherapy or radiotherapy, ondansetron 8 mg administered over 1-2 hours before the start of antineoplastic therapy, followed by the methods of another 8 mg orally after 12 h. For the prevention of late (after 24 hours ) or prolonged vomiting, should continue to receive 8 mg 2 times a day for 5 days after completion of anticancer therapy. To enhance the effect of single dose may be increased to 24 mg and was appointed along with 12 mg of dexamethasone phosphate (as sodium salt) for 1-2 hours before the start of chemotherapy. Children older than 2 years w / 5 mg / m body surface immediately before chemotherapy, followed by oral administration of 4 mg over 12 h. After completion of chemotherapy should continue to receive ondansetron 4 mg 2 times a day for 5 days. Prevention of postoperative nausea and vomiting: Adults enter a period the introduction of general anesthesia / m or / in (slowly) in a dose of 4 mg. For the treatment of nausea and vomiting occurred in the recommended / m or / slow introduction of 4 mg of the drug. V / m in a same area of the body of ondansetron may be administered at a dose not exceeding 4 mg. Children to prevent postoperative nausea and vomiting, ondansetron is used exclusively parenterally in a single dose of 0.1 mg / kg (maximum 4 mg) slowly / in before or after anesthesia. Which developed for the treatment of postoperative nausea and vomiting in children is recommended to slow a / in a single dose of 0.1 mg / kg (maximum 4 mg). As for the prevention and treatment of postoperative nausea and vomiting in children under 2 years not enough experience. When kidney disease and in elderly patients with normal correction of the daily dose and frequency of drug administration is required. When liver damage is largely reduced clearance of ondansetron, increased the T1 / 2 from the plasma and its required dose reduction to 8 mg / day.
Cautions Zofran 4 mg:
Patients who had previously allergic reactions to other selective blockers of 5-HT3-receptor have an increased risk of development against the background of ondansetron. Ondansetron may slow down the motility of the colon, and therefore its function in patients with symptoms of intestinal obstruction requires special monitoring. Infusion solution is prepared immediately before use. If necessary, it can be stored for 24 hours at a temperature of 2-8 degrees C under normal light conditions. During the infusion of protection from light is not required; diluted injection solution remains stable for at least 24 hours in natural light or normal lighting conditions. To prepare the infusion solution can be applied: 0.9% solution of NaCl, 5% dextrose, mannitol 10% solution, Ringer’s solution, 0.3% KCl solution and 0.9% solution of NaCl, 0.3% KCl solution and 5% dextrose. Lingual tablets contain aspartame, it is necessary to consider the appointment of patients with phenylketonuria.
Interaction Zofran 4 mg:
Need to be careful when sharing application: with inducers of the cytochrome CYP2D6 and CYP3A – barbiturates, carbamazepine, carisoprodol, glyutetimid, griseofulvin, dinitrogen oxide, papaverine, phenylbutazone, phenytoin (and presumably other hydantoins), rifampin, tolbutamide, with inhibitors of CYP2D6 and CYP3A enzymes – allopurinol, macrolide antibiotics, antidepressants (MAO inhibitors), chloramphenicol, cimetidine, estrogen oral contraceptives, diltiazem, disulfiram, valproic acid and its salts, erythromycin, fluconazole, fluoroquinolones, isoniazid, ketoconazole, lovastatin, metronidazole, omeprazole, propranolol, quinidine, quinine, verapamil. Ondansetron in the concentration of 16-160 ug / ml pharmaceutically compatible and can be administered through a Y-injector / drip in conjunction with the following drugs: tsisplastin (in concentrations up to 0.48 mg / ml) within 1-8 h, 5-fluorouracil (in concentration of 0.8 mg / ml at 20 ml / h – higher concentrations can cause precipitation of ondansetron) and carboplatin (at a concentration of 0.18-9.9 mg / ml for 10-60 min), etoposide (at a concentration of 0.14-0.25 mg / ml for 30-60 min), ceftazidime (at a dose of 0.25-2 g, as in / bolus over 5 min), cyclophosphamide (at a dose of 0.1-1 g, in the form of I / O bolus injection for 5 min), doxorubicin (at doses of 10-100 mg, as in / bolus over 5 min), dexamethasone: possible w / administration of 20 mg of dexamethasone sodium phosphate slowly for 2-5 minutes. Drugs can be administered through a drip, with a concentration in the solution of dexamethasone sodium phosphate can range from 32 to 2500 pg / ml, ondansetron – from 8 to 100 ug / ml.
