# Ondansetron (Zofran)

Adult oral/IV treatment and the pediatric age-4-and-older ODT pathway.

Population: Adult & pediatric guidance. Scope: ALS.
Status: published. Source-linked OCEMS summary.
Summary updated: 2026-09-16.
Source checked: 2026-09-16.
Source version: I-15 revised March 31, 2026; I-20 revised March 26, 2026. Both implemented April 1, 2026. See linked condition-specific sources..
Canonical page: https://www.ocmedic.com/guides/ondansetron/
Official source: [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf)

Independent OC Medic summary. Does not replace the complete policy, current system notices, or clinical judgment.

## Check before giving

- The adult standing order excludes known or suspected pregnancy.
- Do not let symptom control replace assessment of dehydration, poor perfusion, or an altered level of consciousness.

## Source documents

- [I-15 — Adult / Adolescent Standing Order Drug Guide](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-15%20Adult%20SO%20Drug%20Guide%2004-2026.pdf#page=5)
- [I-20 — Pediatric Medication Volume Dose by Weight](https://www.ochealthinfo.com/sites/healthcare/files/2026-04/I-20%20Peds%20Drug%20Guide%2004-2026.pdf)
- [SO-M-060 — Nausea / Vomiting](https://www.ochealthinfo.com/sites/hca/files/import/data/files/12040.pdf)
- [SO-P-090 — Nausea / Vomiting - Pediatric](https://www.ochealthinfo.com/sites/hca/files/2021-12/SO-P-90%20vomiting.pdf)

## Use in OCEMS

- For ongoing nausea/vomiting in the applicable condition order. Treat associated airway risk and dehydration as well as symptoms.
- The oral dissolving tablet and IV preparation have different dosing instructions.

## Adult / adolescent

| Indication / route | Dose & limits |
| --- | --- |
| ODT | 8 mg (two 4 mg tablets) dissolved orally, once, when pregnancy is not known or suspected. |
| IV | 4 mg IV; may repeat 4 mg once after approximately 3 minutes for continued/recurrent symptoms, when pregnancy is not known or suspected. |

## Pediatric

- SO-P-090: children age 4 and older may receive one 4 mg ODT tablet dissolved orally, as tolerated.
- The cited pediatric nausea standing order does not provide routine IV dosing or an ODT dose below age 4. Do not infer a weight-scaled adult regimen.

## Pediatric dose by age / weight

- SO-P-090 applies to ongoing nausea/vomiting. Age, not weight, determines eligibility for this fixed dose.
| Age / weight | Pediatric dose | Route / limit |
| --- | --- | --- |
| Younger than 4; any weight | No dose in this pediatric standing order | Do not extrapolate from an adult IV dose |
| Age 4 and older; any eligible pediatric weight | 4 mg | One ODT tablet dissolved orally as tolerated |

## Preparation & reassessment

- Stock includes 4 mg ODT and 4 mg/2 mL IV preparations. Verify the product and route.
- Keep suction available when needed. Reassess vomiting, airway protection, perfusion, and treatment response; follow the applicable fluid pathway.