II. Indications
- Chemotherapy associated Nausea
- Radiation Therapy associated Nausea
- Perioperative Nausea and Vomiting
III. Contraindications
IV. Mechanism
- Blocks peripheral and central 5HT3 receptors
- Peripheral 5HT3 receptors at vagal nerve terminals
- Central 5HT3 receptors at ChemoreceptorTrigger Zone in Medulla (area postrema controls Vomiting)
V. Adverse Effects
- See 5-HT3 Antagonist
-
QTc Prolongation (Ondansetron, Dolasetron)
- See Ondansetron
- Higher risk in higher doses, preexisting QTc Prolongation, CHF, Bradycardia, Hypomagnesemia, Hypokalemia
- Serotonin Syndrome
VI. Dosing
-
Nausea with Chemotherapy
- Adult 100 mg orally given 60 minutes before Chemotherapy
- Child age 2 to 16 years: 1.8 mg/kg for single dose up to 100 mg orally given 60 minutes before Chemotherapy
- Prevention of Surgery Related Nausea (Preoperative)
- Surgery Related Nausea or Vomiting (Postoperative)
- Given prophylactically 15 min before Anesthesia ends to prevent Postoperative Nausea and Vomiting
- Adult: 12.5 mg IV for single dose given 15 minutes before end of Anesthesia
- Child: 0.35 mg/kg up to 12.5 mg IV for single dose before end of Anesthesia
VII. Drug Interactions
- Cimetidine increases Dolasetron serum levels
- Rifampin decreases Dolasetron serum levels
VIII. Safety
- Pregnancy Category B
- Unknown safety in Lactation
IX. Resources
X. References
- Hamilton (2020) Tarascon Pocket Pharmacopoeia
- Meyer (2005) Anesth Analg 100(2):373-7 +PMID: 15673860 [PubMed]
- Balfour (1997) Drugs 54(2):273-98 +PMID: 9257083 [PubMed]