by aaronsmommy » Aug 20, 2004 11:54 pm
There is discussion of up to 34.6mg in the literature if your doctor wants a reference, unfortunately it is only an abstract and one that I can't copy right to post here, but your doctor could find the original pretty easily.
This is the protocol that the home health company Matria uses with the subQ pump. It might be worth looking in to that, because it takes the dose worries out of your doctors hands and it gets rid of the hassle of the presciption authorizations.
Monday, May 6, 2002
April 2002
Volume 99, Number 4 (Supplement)
Page 24S
Safety and Efficacy of Ondansetron Therapy for Nausea and Vomiting of Pregnancy*
Lowell McCauley, MD
Ob Gyn Specialists, Knoxville, TN USA
Suzanne Coleman, MSc, RNC, Debbie Jacques, MPH, Beverly Palmer, BSPharm, RPh, and Gary Stanziano, MD
Objective: To examine response to therapy and pregnancy outcomes of women prescribed continuous, subcutaneous ondansetron therapy (SOT) for the treatment of nausea and vomiting of pregnancy (NVP).
Methods: Prospectively collected data from January 2000 to July 2001 from a perinatal data base were analyzed. Inclusion criteria were singleton or twin gestation, 3 days of SOT, Modified Rhodes/PUQE (RP) NVP scoring system at SOT start/stop, side effect(s) data, and pregnancy outcome data. The RP is based on number of vomits, hours of nausea, and number of retches/24 h.
Results: Seventy-five women were included in this analysis. Of these women, 47% had subcutaneous metoclopramide therapy pre SOT; 72% had adjunctive therapies as needed with SOT (antiemetics, acid blockers, intravenous hydration, total parenteral nutrition); 61% were hospitalized pre SOT; 7% reported one or more side effects related to antiemetic therapy; and 40% had weight gain or stabilization. RP: 56% had symptom improvement from SOT start to stop (P < 0.001). Five had first- or early second-trimester abortions; two had perinatal losses: one stillbirth occurred at 29.1 weeks of gestation (2 weeks post SOT) after maternal report of decreased fetal movement, and one neonatal death was due to maternal suicide at 38 weeks (20 weeks post SOT). There were no reported congenital anomalies.
(there is a table that goes here that shows the dose - mean 24mg, min 12, max 34.6 , but I can't get it to copy here)
Conclusion: In this patient population, SOT was a safe and efficacious treatment modality in women with NVP. Subcutaneous ondansetron therapy can be a viable option in patients where conventional therapies have been less than effective.
This document includes a discussion of use of a product that is unapproved by the U.S. Food and Drug Administration.
(Obstet Gynecol 2002:99:24S.
Aimee
Aaron 12/4/02