Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines
(Note: “Therapeutic Interchange” should be placed in the order comments.)
5-HT3 Antagonists
Medication
Ordered
Brand Name
Available Dosages
Frequency
Formulary Medication
Equivalent
Dose
Equivalent Frequency
Granisetron
Kytril
1 mg
Same as ordered
Ondansetron
16 mg
Same as ordered
2 mg
Dolasetron
Anzemet
100 mg
200 mg
*Palonosetron
Aloxi
250 mcg
Once
Ondansetron
16 mg*
Once, may repeat q4h PRN x2 more doses
Note: IV granisetron approved for use in pediatric patients who have failed ondansetron Note: If the dosing falls outside of the above dosing, contact the MD to clarify conversion.
*OLOL P&T approval (April 2022): When ordered from an oncology treatment plan for inpatient administration, the automatic therapeutic interchange for palonosetron 250mcg is ondansetron 8mg once on day 1 and each subsequent day of chemotherapy (if not already on the treatment plan for that day).
Dosage Conversion Guidelines (revised 10/09/2019)
(Note: “Therapeutic Interchange” should be placed in the order comments)
Miscellaneous Antiemetics
Medication
Ordered
Brand Name
Available Dosages
Route
Frequency
Formulary Medication
Equivalent
Dose
Route
Frequency
Trimethobenzamide
Tigan
300mg
PO
q6 or q8h PRN
Ondansetron
4mg
PO
q6h PRN
Tigan inj.
100mg
IM
IM
Exclusions: patients with myeloid malignancies, pediatrics (age <18 years), mobilization, and post-stem cell transplant
Note: Maximum ondansetron dosing: oral=32mg/24 hours; injection=16mg/dose. If the dosing/frequency falls outside of the above dosing strategy, contact the MD to clarify dose/frequency for conversion.
IV Ondansetron FDA Safety Communication
Medications Approved for Automatic Therapeutic Interchange Dosage Conversion Guidelines
(Note: “Therapeutic Interchange” should be placed in the order comments.)
5-HT3 Antagonists
Medication
Ordered
Brand Name
Available Dosages
Frequency
Formulary Medication
Equivalent
Dose
Equivalent Frequency
Granisetron
Kytril
1 mg
Same as ordered
Ondansetron
16 mg
Same as ordered
2 mg
Dolasetron
Anzemet
100 mg
200 mg
*Palonosetron
Aloxi
250 mcg
Once
Ondansetron
16 mg*
Once, may repeat q4h PRN x2 more doses
Note: IV granisetron approved for use in pediatric patients who have failed ondansetron
Note: If the dosing falls outside of the above dosing, contact the MD to clarify conversion.
*OLOL P&T approval (April 2022): When ordered from an oncology treatment plan for inpatient administration, the automatic therapeutic interchange for palonosetron 250mcg is ondansetron 8mg once on day 1 and each subsequent day of chemotherapy (if not already on the treatment plan for that day).
Dosage Conversion Guidelines (revised 10/09/2019)
(Note: “Therapeutic Interchange” should be placed in the order comments)
Miscellaneous Antiemetics
Medication
Ordered
Brand Name
Available Dosages
Route
Frequency
Formulary Medication
Equivalent
Dose
Route
Frequency
Trimethobenzamide
Tigan
300mg
PO
q6 or q8h PRN
Ondansetron
4mg
PO
q6h PRN
Tigan inj.
100mg
IM
IM
Exclusions: patients with myeloid malignancies, pediatrics (age <18 years), mobilization, and post-stem cell transplant
Note: Maximum ondansetron dosing: oral=32mg/24 hours; injection=16mg/dose. If the dosing/frequency falls outside of the above dosing strategy, contact the MD to clarify dose/frequency for conversion.