Anecdotally, we as emergency physicians are fairly comfortable prescribing odansetron to adults with nausea and vomiting. However, emergency physicians often treat pediatric gastroenteritis with a single dose of odansetron in the department. A recent study in NEJM examined effects of discharging with odansetron. Full details can be found in the study, but the take-home:
Sending children home with ondansetron after an emergency visit for gastroenteritis cut the rate of moderate-to-severe illness from 12.5% to 5.1% compared to placebo, with no uptick in adverse events. Those taking ondansetron experienced fewer vomiting episodes in the first 48 hours. Targeted, as-needed dosing helps the sickest children recover faster, while avoiding unnecessary medication for most kids.
References
Freedman SB, Williamson-Urquhart S, Plint AC, et al. Multidose Ondansetron after Emergency Visits in Children with Gastroenteritis. N Engl J Med. 2025;393(3):255-266. doi:10.1056/NEJMoa2503596
