Single daily dosing versus divided dosing intravenous ondansetron to prevent chemotherapy‐induced nausea and vomiting among children: A comparative randomized double‐blind controlled trial

Abstract

Background Chemotherapy‐induced nausea and vomiting (CINV) is a common complication in cancer treatment. Ondansetron is an effective antiemetic drug widely used to prevent CINV; however, the effective administrative dosing strategies among pediatrics remain unclear. The study aimed to investigate clinical effectiveness of single daily dosing versus divided dosing ondansetron. Methods In all, 194 children undergoing chemotherapy were randomized to receive either single daily dosing (0.3 mg/kg/dose) or divided dosing (0.15 mg/kg/dose every 8 hours) intravenous ondansetron for 24 hours. Clinical parameters including number of emesis episodes, nausea scores, appetite levels, parent's satisfaction, and adverse effects within 24 hours were analyzed. Results No significant differences were found between the two dosing strategies concerning number of emesis episodes and parent's satisfaction. However, nonleukemic hematologic malignancies and concurrent administration of intrathecal methotrexate–hydrocortisone–cytarabine (IT‐MHA) were associated with increased risk of acute‐phase vomiting. Interestingly, none of the patients aged under 7 years, receiving divided dosing ondansetron, presented nausea symptoms compared with those receiving single daily dosing (p‐value .034). No significant differences regarding headache were observed between the two dosing strategies and none of the patients experienced QTc prolongation. Conclusion Ondansetron administered as divided dosing should be considered among children aged under 7 years to prevent chemotherapy‐induced nausea and among patients receiving low emetogenic chemotherapy to maintain their appetite. Both administrative dosing strategies were well tolerated with no significant adverse effects.

Improving comprehension, recall and attention using multimedia‐informed assent among pediatric oncology patients: A comparative randomized controlled trial

“…Assent documents for research study, “Single daily dosing versus divided dosing intravenous ondansetron to prevent chemotherapy‐induced nausea and vomiting among children: a comparative randomized double‐blind controlled trial” published by Ruktrirong et al. in the Pediatric Blood and Cancer 2021 Jun;68(6) 20 were used in this study and prepared in both traditional narrative written assent form and multimedia format. Information of the study and important ethical elements of research in both paper‐based and multimedia‐based assent documents were similar and adjusted to the 7–12‐year‐old children's level of maturity.…”

“…A block of four randomizations 19 was employed. After informed consent and assent to take part in the study 20 were used in this study and prepared in both traditional narrative written assent form and multimedia format. Information of the study and important ethical elements of research in both paper-based and multimedia-based assent documents were similar and adjusted to the 7-12-year-old children's level of maturity.…”

The efficacy of single dose palonosetron in highly emetogenic chemotherapy protocols compared to oral aprepitant and ondansetron

“…Common uses of ondansetron include the prevention of CINV, radiationinduced nausea and vomiting, the prevention of postoperative nausea and vomiting, and off-label use for the prevention of nausea and vomiting associated with pregnancy. However, it is not effective for motion sicknessinduced nausea (Ruktrirong et al, 2021).…”

Efficacy of Xiang-Sha-Liu-Jun-Zi on chemotherapy-induced nausea and vomiting

“…[4][5][6][7][8] Chemotherapy-induced nausea and vomiting (CINV) is a common adverse reaction during cancer treatment. [9] The incidence of CINV is as high as 71.4% and 57.3%, respectively. [10] CINV is not conducive to the patient's quality of life and treatment compliance, thereby hindering cancer treatment.…”

“…However, Chemotherapy has become the basic method of treating them [4–8] . Chemotherapy-induced nausea and vomiting (CINV) is a common adverse reaction during cancer treatment [9] . The incidence of CINV is as high as 71.4% and 57.3%, respectively [10] …”