Emeset - instructions for use, reviews, analogs and forms of release (tablets 4 mg and 8 mg, injections in ampoules for injection 2 ml and 4 ml) of the drug for the treatment of nausea and vomiting in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Ameset. Presented are reviews of visitors to the site - consumers of this medication, as well as the opinions of physicians specialists on the use of Emeseta in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Emeset in the presence of existing structural analogues. Use to treat nausea and vomiting caused by cytostatic chemotherapy and radiotherapy, post-operative nausea and vomiting in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Emeset - ondansetron (the active substance of the drug Emeseth) is a selective antagonist of the serotonin receptor (5-HT3). Drugs for cytostatic chemotherapy and radiotherapy can cause an increase in the level of serotonin, which, by activating vagal afferent fibers containing 5-HT3 receptors, induces a vomiting reflex. Ondansetron inhibits the appearance of a vomiting reflex by blocking the 5-HT3 receptors at the neuronal level of both the central and peripheral nervous system.

Composition

Ondansetron (in the form of hydrochloride dihydrate) + auxiliary substances.

Pharmacokinetics

With intramuscular injection, the peak concentration in plasma is reached within 10 minutes. The distribution of ondansetron is the same when administered intravenously and intramuscularly. Absolute bioavailability is about 60%. The drug is metabolized in the liver. The binding with plasma proteins is 70-76%. Less than 5% of the drug is excreted in the unchanged form.

Indications

• prevention and elimination of nausea and vomiting caused by cytostatic chemotherapy and radiotherapy, as well as postoperative nausea and vomiting.

Forms of release

Tablets coated with 4 mg and 8 mg.

Solution for intravenous and intramuscular injection 2 ml and 4 ml.

Instructions for use and dosing regimen

Cytostatic therapy.

The choice of the dosage regimen is determined by the severity of the emetogenic effect of the antitumor therapy.

Adults are usually prescribed in a daily dose of 8-32 mg, the following regimens are recommended:

With moderate emetogenic chemotherapy or radiotherapy:

• 8 mg intravenously struino slowly or intramuscularly, immediately before the start of therapy;
• 8 mg orally 1 to 2 hours before the start of therapy, then another 8 mg orally 12 hours after the start of therapy.

With highly emeticogenic chemotherapy:

• 8 mg intravenously struino slowly just before chemotherapy, and then two further intravenous jet injections of 8 mg, each of which is carried out in 2-4 hours;
• continuous 24-hour infusion of the drug at a dose of 24 mg at a rate of 1 mg per hour;
• 16-32 mg, diluted in 50-100 ml of the appropriate infusion solution, as a 15-minute infusion, immediately before the start of chemotherapy.

The effectiveness of the Emeseta can be increased by a single intravenous injection of a glucocorticosteroid (eg,20 mg dexamethasone) prior to chemotherapy; when ingested to enhance the effect of a single dose can be increased to 24 mg and administered simultaneously with 12 mg of Dexamethasone 1-2 hours before the start of chemotherapy. To prevent delayed (occurring 24 hours after the initiation of chemotherapy or radiotherapy) vomiting, it is recommended to continue the use of the drug inside as tablets 8 mg twice a day for 5 days.

For children over the age of 2, the drug is given at a dose of 5 mg per square meter of the body surface intravenously, immediately before the start of chemotherapy, followed by oral administration at a dose of 4 mg after 12 hours; after the end of chemotherapy it is recommended to continue treatment 4 mg 2 times a day inside within 5 days.

Prevention of postoperative nausea and vomiting

Adults injected a single dose of 4 mg intramuscularly or intravenously slowly at the beginning of anesthesia or administered 16 mg orally 1 hour prior to the onset of anesthesia.

For relief of nausea and vomiting, intramuscular or slow intravenous administration of 4 mg of the drug is recommended.

Intramuscularly in the same part of the body, Emeset can be administered at a dose not exceeding 4 mg!

For children to prevent postoperative nausea and vomiting, Emeset is used exclusively parenterally in a single dose of 0.1 mg per kilogram (maximum 4 mg) in the form of a slow intravenous injection before or after anesthesia.

To treat the development of postoperative nausea and vomiting in children, a slow intravenous injection of a single dose of 0.1 mg per kilogram (maximum 4 mg) is recommended.

In the prevention and treatment of postoperative nausea and vomiting in children under 2 years of age, there is no sufficient experience.

Elderly patients - dosage changes are not required.

Patients with impaired renal function - if renal dysfunction does not change the usual daily dose and the frequency of drug administration is not required.

In patients with impaired hepatic function, Emeset's clearance is significantly reduced, and the half-life of the patient is increased from the plasma, therefore, a daily dose of 8 mg should not be exceeded.

To dilute the injection solution, the following solutions can be used:

• 0.9% solution of sodium chloride;
• 5% dextrose solution;
• Ringer's solution;
• 0.3% potassium chloride solution and 0.9% sodium chloride solution;
• 0.3% potassium chloride solution and 5% dextrose solution.

Side effect

• headache;
• dizziness;
• spontaneous movement disorders and convulsions;
• pain in the chest;
• arrhythmias, bradycardia;
• lowering blood pressure;
• hiccough;
• dry mouth;
• diarrhea, constipation;
• hives;
• bronchospasm;
• laryngospasm;
• angioedema (swelling of the subcutaneous tissue, skin and mucous membranes);
• anaphylaxis (acute, life-threatening reaction to one or another allergen, accompanied by swelling, suffocation, muscle spasms and severe pain);
• Pain, burning and redness at the injection site;
• flushed face;
• feeling of heat;
• temporary impairment of visual acuity;
• hypokalemia (low content of potassium in the blood).

Contraindications

• pregnancy and the period of breastfeeding;
• children under 2 years of age (safety and efficacy not studied);
• hypersensitivity to any component of the drug.

Application in pregnancy and lactation

Emeset is contraindicated for use in pregnancy and lactation.

Use in children

The drug is not prescribed for children under 2 years of age.

In the prevention and treatment of postoperative nausea and vomiting in children under 2 years of age, there is no sufficient experience.

Application in elderly patients

When using the drug in elderly patients with normal liver function, there is no need for correction of the dosing regimen.

special instructions

In patients who have previously experienced hypersensitivity reactions with other selective 5HT3 receptor antagonists, similar reactions may also occur with the use of Emeseta.

Since ondansetron slows the bowel motility, patients with signs of intestinal obstruction after using the drug require special observation.

The infusion solution should be prepared immediately before use. If necessary, the ready-made infusion solution can be stored for up to 24 hours at a temperature of 2-8 degrees Celsius.

During the infusion, protection from light is not required; The diluted injection solution retains its stability for at least 24 hours under natural light or normal light.

Drug Interactions

Since ondansetron is metabolized by the enzyme system (cytochrome P450) of the liver, caution is required when combined:

• with enzymatic inducers P450 (CYP2D6 and CYP3A) (barbiturates, carbamazepine, carisoprodol, glutetimide, griseofulvin, nitrous oxide, papaverine, phenylbutazone, phenytoin (probably other hydantoins), rifampicin, tolbutamide);
• with inhibitors of enzymes P450 (CYP2D6 and CYP3A) (allopurinol, macrolide antibiotics, antidepressants - MAO inhibitors, chloramphenicol, cimetidine, oral contraceptives containing estrogens, diltiazem, disulfiram, valproic acid, sodium valproate, erythromycin, fluconazole, fluoroquinolones, isoniazid, ketoconazole, lovastatin, metronidazole, omeprazole, propranolol, quinidine, quinine, verapamil).

Analogues of the drug Emeset

Structural analogs for the active substance:

• Vero-Ondansetron;
• Domegan;
• Zofran;
• Lazaran VM;
• Latran;
• Ondwell;
• Ondansetron;
• Ondantor;
• Sturgeon;
• Stronon;
• The Emetron.

Analogues on the curative effect (remedies for the treatment of nausea and vomiting):

• Aviamarin;
• Bactistatin;
• Beviplex;
• Betagistin;
• Betaserc;
• Bimaral;
• Werthran;
• Vestibo;
• Haloperidol;
• Ganaton;
• Glucosterol;
• Decadron;
• Domperidone;
• Dramina;
• Zofran;
• Iberogast;
• Itomed;
• Itopra;
• Yonosterol;
• Carmolis drops;
• Kinedryl;
• Citril;
• Latran;
• Lemodus;
• Laurafen;
• Maksilak;
• Maksilak Baby, synbiotic (probiotic + prebiotic);
• Metamol;
• Metizred;
• Metovit;
• Metoclopramide;
• Motilac;
• Motilium;
• Motion;
• Nobrethum;
• Novocaine;
• Odeston;
• Omez;
• Omeprazole;
• Sturgeon;
• Papaverine;
• Passion;
• Perinorm;
• Pipolphen;
• Propazine;
• Raglan;
• Senorm;
• Torekan;
• Trimedate;
• Triftazine;
• Tropindol;
• Fezam;
• Hofitol;
• Ceruglan;
• Cerucal;
• Cinnaron;
• Emend;
• Emetron;
• Etaperazine.

Review of the oncologist's doctor

Preparations for chemotherapy, as well as radiation exposure, always cause an increase in the serotonin level in the body, which irritates the emetic center of the brain, which causes severe nausea and vomiting in patients. Similarly, various drugs work for anesthesia. To facilitate or completely eliminate such a serious side effect, I always apply Ameset. During the work with the drug I can give him exceptionally positive feedback. The active substance Emeseta ondansetron effectively blocks the work of the vomiting center.The use of the drug almost completely solves the problem of preventing nausea and vomiting in patients receiving chemotherapy and radiation treatment of patients. The effect is proved in practice.

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