Ondansetron is a selective 5-HT receptor antagonist 3 (serotonin). Cytostatic drugs for chemotherapy and radiotherapy may cause an increase in the level of serotonin, which by activation of vagal afferent fibers containing receptors 5-HT 3 causes the gag reflex.Ondansetron inhibits occurrence gag reflex by blockade of 5-HT receptor 3 neuronal level both central and peripheral nervous system. Apparently, this mechanism of action is based prevention and treatment of postoperative and induced cytostatic chemotherapy and radio-therapy, nausea and vomiting. Possesses anxiolytic activity without causing sedation, impaired coordination of movements, buy primobolan or reduce the activity and performance. Is used for the symptomatic treatment of alcohol withdrawal syndrome, mild to moderate severity, acting on the somatic and psychiatric symptoms. When administered intramuscularly peak concentration is achieved within 10 minutes in the plasma. Distribution ondansetron equally at oral, intramuscular and intravenous administration. After oral ondansetron maximum concentration in plasma is achieved after about 1.5 hours. The absolute bioavailability is about 60%. The drug is metabolized in the liver. Plasma protein binding is 70-76%. The urine in an unmodified form at least 5% released drug. As after ingestion or by parenteral administration half-life is about 3 hours in the elderly may reach 5 hours and in severe hepatic impairment -. 15-32 hours. When kidney disease (renal clearance less than 15 mL / min) to increase the half-life of 4-5 hours, but this increase has no clinical significance.
Prevention and elimination of the nausea and vomiting that occur during cytostatic chemotherapy rentgenoradioterapii, or other forms of radiation exposure, as well as post-operative nausea and vomiting.
Symptomatic treatment of alcohol withdrawal syndrome (mostly mild to moderate).
- Hypersensitivity to any component of the drug
- Pregnancy and lactation.
- Children under 2 years (safety and efficacy has not been studied)
Dosage and administration of cytostatic therapy . The choice of dosage regimen is determined by the emetogenic anticancer therapy for adult daily dose usually is 8-32 mg, the following modes are recommended. In moderate emetogenic chemotherapy or radiotherapy:
- 8 mg slowly intravenously or intramuscularly, immediately before therapy;
- 8 mg orally (2 tablets) for 1-2 hours prior to treatment, and then an additional 8 mg (2 tablets) over 12 hours after initiation of therapy.
When vysokoemetogennoy chemotherapy:
- 8 mg slowly intravenously immediately before the start of chemotherapy and then two intravenous injections of 8 mg each of which is carried out in 2-4 hours;
- 24-hour continuous infusion of drug at a dose of 24 mg at 1 mg / hour;
- 16-32 mg diluted in 50-100 ml of the appropriate infusion solution in the form of 15-minute infusion, immediately before chemotherapy.
Efficacy Latran ® can be increased by a single intravenous injection of a glucocorticoid (e.g. deksamegazona 20 mg) prior to chemotherapy; when administered to enhance the effect of a single dose may be increased to 24 mg, and both assigned to 12mg deksamegazona for 1-2 hours prior to chemotherapy.
For the prevention of delayed emesis occurring after the first 24 hours from the start of chemotherapy is recommended to continue applying Latran ® orally in the form of tablets 8 mg (2 tablets of 4 mg), 2 times a day for 5 days. Children children over 2 years of drug administered in a dose of 5 mg / m2 body surface intravenously immediately before chemotherapy beginning followed by ingestion 4 mg over 12 hours; after chemotherapy is recommended to continue the treatment with 4 mg twice a day orally for 5 days. The prevention of postoperative nausea and vomiting Adults administered a single dose of 4 mg intramuscularly or intravenously, slowly at the beginning of the anesthesia or prescribed 16 mg orally for 1 hour before anesthesia. for relief occurred nausea and vomiting recommended intramuscular or slow intravenous administration of 4 mg. intramuscular in the same Latran body may be administered at a dose not exceeding 4 mg! Babies for prevention of postoperative nausea and vomiting applied exclusively parenterally in a single dose 0.1 mg / kg (up to 4 mg) as a slow intravenous injection prior to or after anesthesia. For the treatment of which developed post-operative nausea and vomiting in children recommended slow intravenous administration of a single dose. With regard to the prevention and treatment of postoperative nausea and vomiting in children under 2 years enough experience there. When exposed to ionizing radiation is taken orally in a single dose of 8 mg (2 tablets) 1 hour prior to or just after radiation buy primobolan exposure. For the symptomatic treatment of alcohol withdrawal syndrome drug is administered intravenously at a dose of 8 mg per 400 ml gemodeza, Chlosol or 0.9% sodium chloride solution. If necessary, the possible re-introduction of the drug Latran ® . Elderly patients dosage change is required. Patients with kidney and liver lesions With the defeat of the kidneys to change the usual daily dose and frequency of dosing is required. When liver disease is largely ondansetron decreased clearance, and increased its half-life time of the plasma, so it is necessary to reduce the dose to 8 mg per day. The following solutions can be used to reconstitute the injectable solution: 0.9% sodium chloride solution, 5% dextrose solution, Ringer’s solution, 0.3% chloride and 0.9% sodium chloride potassium chloride 0.3% and 5% dextrose potassium.
Side effects: Allergic reactions: urticaria, bronchospasm, laryngospasm, angioedema, anaphylaxis. From the digestive system: hiccups, dry mouth, diarrhea, constipation, sometimes asymptomatic transient increase in serum aminotransferase levels. On the part of the cardiovascular system: chest pain in some cases with ST segment depression, arrhythmia, bradycardia, decreased blood pressure. from the nervous system: headache, dizziness, spontaneous movement disorders and seizures. Local reactions: pain, burning and redness at the injection site. Other: a rush of blood to the face, burning sensation, temporary disruption of visual acuity, rarely -gipokaliemiya (connection with taking the drug is not clearly established).
Interactions with other drugs
Because ondansetron is metabolized by the enzyme system (cytochrome P450) of the liver, caution is required when used together:
- P450 enzyme-inducers (of CYP2D6 and of CYP3A) (barbiturates, carbamazepine, carisoprodol, glutetimid, griseofulvin, dinitrogen oxide, papaverine, phenylbutazone, phenytoin (probably other hydantoins), rifampicin, tolbutamide);
- with P450 enzyme inhibitors (CYP2D6 and CYP3A) (allopurinol, macrolide antibiotics, antidepressants – MAO inhibitors, chloramphenicol, cimetidine, oral contraceptives containing estrogens, diltiazem, disulfiram, valproic acid, sodium valproate, erythromycin, fluconazole, fluoroquinolones, isoniazid, ketoconazole, lovastatin, metronidazole, omeprazole, propranolol, quinidine, quinine, verapamil).
In case of suspected overdose symptomatic therapy is shown.
In case of overdose pills Latran use of ipecac is not recommended, since it is unlikely that this drug will be effective during the antiemetic action of ondansetron.
A specific antidote is not known.
In patients who have previously in the application of other selective antagonists of the 5HT 3 receptor. hypersensitivity reactions were observed when applying buy primobolan also may develop analogous reactions.
Since Ondansetron can cause constipation, patients with evidence of ileus after treatment requires regular monitoring.
infusion solution should be prepared immediately before use. If necessary, the finished infusion solution can be stored until use for a maximum period of 24 hours at a temperature of 2-8 ° C.
During the infusion protection from light is required; Injection diluted retains its stability for at least 24 hours in normal or natural light illumination. Running low dose t3 clen cycle trying to lose bodyfat isn’t a real hot idea imo.