Ondansetron 4mg/5ml Syrup
Thame Laboratories
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Thame Laboratories —
Package leaflet: Information for the user
Ondansetron 4mg/5ml Syrup
(ondansetron as ondansetron hydrochloride dihydrate)
Read all of this leaflet carefully before you start taking this medicine because it contains important information for you.
► Keep this leaflet. You may need to read it again.
► If you have any further questions, ask your doctor or pharmacist.
► This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their signs of illness are the same as yours.
► If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. See section 4.
The name of your medicine is Ondansetron 4mg/5ml Syrup but it will be referred as Ondansetron throughout this leaflet.
What is in this leaflet
1. What Ondansetron is and what it is used for
2. What you need to know before you take Ondansetron
3. How to take Ondansetron
4. Possible side effects
5. How to store Ondansetron
6. Contents of the pack and other information
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1. What Ondansetron is and
what it is used for
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Ondansetron contains the active substance ondansetron hydrochloride dihydrate. This belongs to a group of medicines called antiemetics.
Ondansetron is used for:
► preventing nausea and vomiting caused by chemotherapy or radiotherapy for cancer
► preventing nausea and vomiting after surgery.
Ask your doctor, nurse or pharmacist if you would like any further explanation about these uses.
2. What you need to know before —you take Ondansetron
Do not take Ondansetron if:
► you are allergic (hypersensitive) to Ondansetron or any of the other ingredients of this medicine (listed in section 6). Signs of an allergic reaction include: a rash, swallowing or breathing problems, swelling of your lips, face, throat or tongue
► you are taking apomorphine (used to treat Parkinson's disease)
Warnings and Precautions Talk to your doctor or pharmacist before taking Ondansetron if:
► you have ever had heart problems (e.g. congestive heart failure which causes shortness of breath and swollen ankles)
► you have an uneven heart beat (arrhythmias)
► you are allergic to medicines similar to ondansetron, such as granisetron
► you have liver problems
► you have a blockage in your gut
► you have problems with the levels of salts in your blood, such as potassium, sodium and magnesium.
If you are not sure if any of the above apply to you, talk to your doctor or pharmacist.
Children
Do not give this medicine to children under 6 months of age
Other medicines and Ondansetron
Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines. This includes medicines obtained without a prescription and herbal medicines.
Ondansetron should not be taken at the same time as other medicines.
This is because Ondansetron can affect the way other medicines work.
Also some medicines can affect the way Ondansetron works.
In particular, tell your doctor, nurse or pharmacist if you are taking any of the following medicines:
► carbamazepine or phenytoin used to treat epilepsy
► rifampicin used to treat infections such as tuberculosis (TB)
► antibiotics such as erythromycin or ketoconazole
► anti-arrhythmic medicines used to treat an uneven heart beat
► beta-blocker medicines used to treat certain heart or eye problems, anxiety or prevent migraines
► tramadol, a pain killer
► medicines that affect the heart (such as haloperidol or methadone)
► cancer medicines (especially anthracyclines and trastuzumab)
► SSRIs (selective serotonin reuptake inhibitors) used to treat depression and/or anxiety including fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, escitalopram
► SNRIs (serotonin noradrenaline reuptake inhibitors) used to treat depression and/or anxiety including venlafaxine, duloxetine.
If you are not sure if any of the above applies to you, talk to your doctor or pharmacist before having Ondansetron.
Pregnancy and breast-feeding
It is not known if Ondansetron is safe during pregnancy. If you are pregnant, think you are pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking Ondansetron.
Do not breast-feed if you are taking Ondansetron. This is because small amounts pass into the mother's milk. Ask your doctor or midwife for advice.
Ondansetron contains:
This medicine contains sorbitol, liquid (non-crystallising) (E420). Calorific value 2.6 kcal/g sorbitol. If you have been told by your doctor that you have an intolerance to some sugars, speak to your doctor before taking this medicine. Sorbitol may have a mild laxative effect. This medicine contains sodium benzoate (E211), which may increase jaundice (yellowing of the skin and eyes) in pre-term and full-term jaundiced neonates. This product contains 14.74mg/5ml propylene glycol as an ingredient neccessory for the medicine to work properly.
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3. How to take Ondansetron
Always take this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure.
The dose you have been prescribed will depend on the treatment you are having.
Do not mix Ondansetron with anything (not even water) before swallowing it.
Doses
The recommended dose is:
To prevent nausea and vomiting from chemotherapy or radiotherapy
Adults:
On the day of chemotherapy or radiotherapy
► the usual dose is 10ml (8mg) taken one to two hours before treatment and another 10ml (8mg) twelve hours after.
On the following days
► the usual dose is 10ml (8mg) twice a day, this may be given for up to 5 days.
Children and adolescents (6 months to 17 years):
The doctor will decide the dose depending on the child's size (body surface area) or weight.
► the usual dose for a child is up to 5ml (4mg) twice a day
► this can be given for up to 5 days.
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PIL/UK/MFG101/03/v2
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To prevent nausea and vomiting
after an operation
Adults:
The usual dose is 20ml (16mg) before your operation.
Children aged over 1 month and adolescents:
It is recommended that Ondansetron is given as an injection.
Patients with moderate or severe liver problems:
The total daily dose should not be more than 10ml (8mg).
Ondansetron should start to work within one or two hours of taking a dose.
If you are sick (vomiting) within one hour of taking a dose:
► take the same dose again
► otherwise, do not take more Ondansetron than recommended.
If you continue to feel sick, tell your doctor.
Method of administration:
► use the 2.5-5ml double-ended spoon supplied in the pack (see below) to measure the required dose
► swallow the solution
► wash the spoon with clean water after taking every dose
► once measured, the solution should be consumed within 3 hours.
Double-ended Spoon
If you take more Ondansetron than you should If you or your child take more Ondansetron than you should, talk to a doctor or go to a hospital straight away. Take the medicine pack with you.
If you forget to take Ondansetron
If you forget a dose and feel sick or vomit, take it as soon as you remember. However, if it is nearly time for the next dose, skip the missed dose. Do not take a double dose to make up for a forgotten dose.
If you forget a dose but do not feel sick, take the next dose. Do not take a double dose to make up for a forgotten dose.
If you stop taking Ondansetron
Keep taking this medicine until your doctor tells you to stop. Do not stop taking Ondansetron just because you feel better.
If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
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4. Possible side effects
Like all medicines, this medicine can cause side effects, although not everybody gets them.
Stop taking Ondansetron and contact your doctor immediately if you develop the following symptoms:
► You have an allergic reaction. The signs may include: a rash, swallowing or breathing problems, chest pain or tightness, swelling of your lips, face, throat or tongue and collapse.
Other side effects include:
Very common (affects more than 1 in 10 people)
► Headache.
Common (affects less than 1 in 10 people)
► a feeling of warmth or flushing
► constipation
► changes to liver function test results (if you take Ondansetron with a medicine called cisplatin, otherwise this side effect is uncommon).
Uncommon (affects less than 1 in 100 people)
► hiccups
► low blood pressure, which can make you feel faint or dizzy
► uneven heart beat
► chest pain
► fits
► unusual body movements or shaking.
Rare (affects less than 1 in 1,000 people)
► feeling dizzy or light headed
► blurred vision
► disturbance in heart rhythm (sometimes causing a sudden loss of consciousness).
Very rare (affects less than 1 in 10,000 people)
► poor vision or temporary loss of eyesight, which usually comes back within 20 minutes.
Reporting of side effects
If you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via
www.mhra.gov.uk/yellowcard By reporting side effects you can help provide more information on the safety of this medicine.
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5. How to store Ondansetron
► Keep this medicine out of the sight and reach of children.
► Do not use this medicine after the expiry date, which is printed on the carton and bottle after 'Exp'. The expiry date refers to the last day of that month.
► This medicinal product does not require any special storage conditions.
► Discard 60 days after first opening.
► Do not take this medicine if you notice that the solution becomes discoloured or shows any signs of deterioration. Seek the advice of your pharmacist.
► Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to dispose of medicines you no longer use. These measures will help protect the environment.
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6. Contents of the pack and other information
What Ondansetron contains
The active substance is ondansetron hydrochloride dihydrate.
Each 5ml syrup contains 4mg ondansetron as ondansetron hydrochloride dihydrate.
The other ingredients are citric acid monohydrate (E330), sodium citrate (E331), sorbitol, liquid (non crystallising) (E420), sodium benzoate (E211), strawberry flavour (contains propylene glycol (E1520)) and purified water.
What Ondansetron looks like and contents of the pack
Ondansetron is a clear, colourless syrup with a strawberry flavour. It is supplied in type III amber colour glass bottle with HDPE, EPE wadded, tamper evident, child resistant screw on white plastic polypropylene cap.
The pack also contains a plastic double ended spoon with the smaller end measuring 2.5ml and the larger end measuring 5ml.
Ondansetron is supplied in bottles containing 50ml, 100ml and 300ml syrup.
Not all pack sizes may be marketed.
Marketing Authorisation Holder and Manufacturer:
Syri Limited t/a Thame Laboratories,
Unit 4, Bradfield Road,
Ruislip, Middlesex, HA4 0NU, UK.
This leaflet was last revised in 12/2015.
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Thame Laboratories
PIL/UK/MFG101/03/v2