I went to the pharmacy to find out what the next size dose-strength was and learnt it was 8mg (currently Pam is on 4mg). The pharmacist advised that rather than increasing the dose amount, consider a variation as to how it is delivered.
Pam currently has the 4mg tablet dissolved in water and delivered via her PEG tube into her jejunum (middle small intestine). What the pharmacist was proposing was to make available dissolvable Ondansetron wafers which would be given to Pam under her tongue. He explained that this would affect a quicker relief and possibly a more intense relief.
I asked Pam as to how she felt about dissolving a wafer in her mouth, but she thought it was potentially a GOOD idea, so I went to see Dr Bob to get a prescription for this new format. When I picked it up, I noticed (with a smile) that the wording on the prescription was for “Ondansetron 4mg orally disintegrating tablets”, but what I got when I had it filled by the pharmacist was “ONDAZ-ZYDIS WAFER 4MG 10 (ONDANSETRON)”. The pharmacist (Tim DeBoo) went to some trouble to explain how to remove the tablets from the packaging without disintegrating them. (Whacko! They still disintegrate and are indeed tablets, not wafers – even though what is printed on their box is exactly what’s in uppercase above.)
I am yet to find out what it’s like to actually do it, but I dare it’s just a matter of time. I still have plenty of ordinary tablets and will continue to use them unless Pam’s nausea-needs demand something better.