Antiemetic drugs for acute gastroenteritis
For children with acute gastroenteritis, ondansetron reduces vomiting, improves intake of oral rehydration solutions, and reduces the need for intravenous fluids and hospitalisationNino-Serna, 2020Tomasik, 2016. It is well tolerated, but can worsen diarrhoea (possibly due to retention of fluids and toxins normally eliminated by vomiting). If ondansetron is considered appropriate for a child with acute gastroenteritis, use:
ondansetron (child 6 months or older) 0.15 mg/kg up to 8 mg orally. Repeat dose after 8 to 12 hours if necessary 1. ondansetron ondansetron ondansetron
In children who cannot tolerate oral medications, ondansetron may be given intravenously. Dopamine receptor antagonists (eg metoclopramide, prochlorperazine) can cause extrapyramidal adverse effects and should be used with caution in children2.
For adults, antiemetic drugs used for acute gastroenteritis include dopamine receptor antagonists (eg metoclopramide, prochlorperazine), droperidolFuryk, 2015Braude, 2006Ernst, 2000 and 5-HT3–receptor antagonists (eg ondansetron)Silverman, 2019. Suitable oral regimens include:
1metoclopramide 10 mg orally, 8-hourly if required metoclopramide metoclopramide metoclopramide
OR
1ondansetron 4 to 8 mg orally, 8- to 12-hourly if required1 ondansetron ondansetron ondansetron
OR
1prochlorperazine 20 mg orally, for the first dose, then 10 mg 2 hours later, then 5 to 10 mg 8-hourly if required. prochlorperazine prochlorperazine prochlorperazine
If oral antiemetic therapy is not tolerated or parenteral therapy is preferred, see Antiemetic drugs in adults for parenteral dosages.