North East and North Cumbria
ICS Formulary
4 Central nervous system
04-06 5HT3 antagonists
Ondansetron
First Choice
The cheapest available formulation should be used.
Ondansetron 4mg and 8mg oro-dispersible tablets/films are approved for the treatment of post-operative nausea and vomiting in patients who do not require IV access or are nil by mouth
MHRA Drug Safety Update (Jan 2020): Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy
Palonosetron
Formulary
Only approved for the second line treatment of chemotherapy induced nausea vomiting only.
Netupitant & Palonosetron
Akynzeo
®
Formulary
To be used in accordance with Northern England Strategic Clincial Cancer Network (NCCN) Guidelines
Links
Chemotherapy Induced Nausea and Vomiting (CINV) Anti-emetic Guidelines
Chemotherapy Induced Nausea and Vomiting (CINV) Anti-emetic Guidelines
Metoclopramide: risk of neurological adverse effects
MHRA Drug Safety Alert (Feb 2015): Drugs and driving: blood concentration limits set for certain drugs
MHRA Drug Safety Alert (Jul 2013): Ondansetron for intravenous use: dose-dependent QT interval prolongation
MHRA Drug Safety Alert (May 2014): Domperidone: risk of cardiac side effect
MHRA Drug Safety Update (Dec 2019): Domperidone for nausea and vomiting: lack of efficacy in children; reminder of contraindications in adults and adolescents
MHRA Drug Safety Update (Jan 2020): Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy
MHRA Drug Safety Update (Jan 2020): Ondansetron: small increased risk of oral clefts following use in the first 12 weeks of pregnancy
NENC Palliative and End of Life Care Symptom Control Guidelines
NICE CG84: Vomiting and diarrhoea in children under 5
NICE NG155: Tinnitus: assessment and management
NICE NG62: Cerebral palsy in under 25s: assessment and management
NICE TA614: Cannabidiol with clobazam for treating seizures associated with Dravet syndrome
NICE TA615: Cannabidiol with clobazam for treating seizures associated with Lennox–Gastaut syndrome
TEWV - Medicines Optimisation – Interactive Guide
TEWV Guidelines
TEWV Safe Transfer of Prescribing Guidance
Key
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