Emeset (Ondansetron)
Also sold as: Emeset, Vomikind, Onset, Emset
Pregnancy
Cat B
Lactation
Caution
Schedule
H
Forms
Tablet 4/8mg +3
Indications
- Chemotherapy-induced nausea/vomiting (CINV)
- Post-operative N/V
- Acute gastroenteritis (off-label)
- Hyperemesis gravidarum (specialist)
Adult Dosing
CINV
8 mg PO/IV 30 min pre-chemo, then 8 mg q12h × 24-48h
PONV
4-8 mg IV stat
Gastroenteritis
4-8 mg PO single dose
Pediatric Dosing
For gastroenteritis: 0.15 mg/kg single dose to facilitate oral rehydration
Renal Dose Adjustment
| CrCl / eGFR | Dose Adjustment |
|---|---|
| No adjustment needed | No CrCl-based dose adjustment required |
Hepatic Adjustment
Severe: max 8 mg/day
Pregnancy & Lactation
Pregnancy: Category B
Some studies suggest small increase in cleft palate risk (1st trimester) — use only if benefits outweigh risks
Lactation: Caution
Top Drug Interactions
| Interacting Drug | Effect | Severity |
|---|---|---|
| QT-prolonging drugs (azithromycin, citalopram, haloperidol) | Additive QT prolongation | Major |
| Apomorphine | CONTRAINDICATED — severe hypotension | Major |
| Tramadol | Reduced tramadol analgesic effect | Moderate |
| Serotonergic drugs (SSRIs, SNRIs, MAOIs) | Serotonin syndrome risk | Moderate |
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Side Effects
Common
- Headache
- Constipation
- Fatigue
- Diarrhea
Serious / Discontinue If
- QT prolongation, Torsades
- Serotonin syndrome
- Anaphylaxis
Contraindications
- Concomitant apomorphine
- Congenital long QT syndrome
Available Indian Brands
| Brand | Manufacturer | Price (approx) |
|---|---|---|
| Emeset 4 | Cipla | 10 tab ₹65 |
| Vomikind 4 | Mankind | 10 tab ₹45 |
| Onset 4 | Sun Pharma | 10 tab ₹75 |
Monitoring Required
- ECG (QT) in patients with risk factors
Patient Counseling Points
- Can be taken with or without food
- Report palpitations
- May cause constipation — increase water intake
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References
- BNF
- Lexicomp Drug Information
- Indian National Formulary
- Specialty society guidelines (RSSDI/CSI/IAP)