Ondansetron Pediatric dose

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ondansetron pediatric dosing guidelines 2024

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Here is a complete summary of ondansetron pediatric dosing:

Ondansetron (Zofran) - Pediatric Dosing

Oral (moderately emetogenic chemotherapy):

Age	Dose	Schedule
4-11 years	4 mg	30 min before chemo, then 4h and 8h after first dose; then 4 mg TID x 1-2 days
12-17 years	8 mg	30 min before chemo, then 8h after; then 8 mg TID x 1-2 days

IV (highly emetogenic chemotherapy):

≥6 months: 0.15 mg/kg IV (max 8 mg/dose), given 30 min before chemo, repeated at 4h and 8h
Infuse each dose over 15 minutes

IV dose (age 1 month to 12 years):

Weight	Dose
≤40 kg	0.1 mg/kg IV
>40 kg	4 mg IV (flat dose)

Administer over at least 30 seconds (preferably 2-5 minutes)
Give immediately before induction OR postoperatively if vomiting occurs within 2 hours of surgery

Typically a single dose is sufficient for outpatient gastroenteritis
Available as oral solution (4 mg/5 mL), tablets, or ODT (orally disintegrating tablet)

Minimum age: 1 month (IV); 6 months (some CINV protocols)
Max single IV dose: 16 mg (risk of QTc prolongation above this)
Severe hepatic impairment (Child-Pugh ≥10): Max 8 mg/day
QTc monitoring: Use with caution in patients on other QT-prolonging drugs or with congenital long QT syndrome
No dose adjustment needed for renal impairment or mild-moderate hepatic impairment

Dilute in 50 mL NS or D5W before infusion (for infants ≤10 kg or ≤1 year, may use 10-50 mL)
Infuse over 15 minutes for CINV; over 2-5 minutes for PONV

Sources: FDA Prescribing Information (Zofran), Children's Mercy Hospital CPG, StatPearls (NIH), Tintinalli's Emergency Medicine

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