II. Management

  1. Medication taken within 15 minutes of Vomiting (or intact drug seen in Emesis)
    1. May re-dose medication
  2. Medication taken within 15-60 minutes of Vomiting
    1. May re-dose medication IF risk of missed dose outweighs risk of extra dose
    2. Re-dose in most cases of antimicrobials (e.g. Hepatitis C, HIV, Chlamydia)
    3. Consult with oncology regarding Chemotherapy medications
    4. Consult with transplant team regarding Immunosuppressants
    5. Combination Oral Contraceptives do not typically need re-dosing
    6. Avoid re-dosing of medications at higher risk of toxicity
      1. Avoid re-dosing Anticoagulants, Antihypertensives, Methotrexate, Phenytoin
      2. Avoid re-dosing Acetaminophen or Opioids
    7. Avoid re-dosing medications in which a missed dose will have little impact
      1. Long Half-Life medications (e.g. Amiodarone, Fluoxetine)
      2. Medications intended for longterm prevention (e.g. Statins, Bisphosphonates)
    8. Avoid re-dosing medications with rapid absorption
      1. Chewable, liquid or dissolving medications (e.g. sublingual or buccal medivcations)
  3. Medication taken within 3 hours of Vomiting
    1. Re-dose Progestin-Only PillContraception or Emergency Contraception

III. References

  1. (2020) Presc Lett 27(2): 7-8

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