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ondansetron (Injection route)

Pronunciation

on-DAN-se-tron

Commonly used brand name(s)

In the U.S.

  • Zofran

Available Dosage Forms:

  • Solution

Therapeutic Class: Antiemetic

Pharmacologic Class: Serotonin Receptor Antagonist, 5-HT3

Uses For ondansetron

Ondansetron injection is used to prevent the nausea and vomiting that may occur after treatment with cancer medicines (chemotherapy or radiation), including high-dose cisplatin. ondansetron is also used to prevent and treat nausea and vomiting that may happen after surgery.

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ondansetron is available only with your doctor's prescription.

Before Using ondansetron

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ondansetron, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ondansetron or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of ondansetron injection in children. However, safety and efficacy have not been established in children being treated for nausea and vomiting due to cancer treatments who are younger than 6 months of age for the prevention of nausea and vomiting from surgery in children younger than 1 month of age.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ondansetron injection in the elderly.

Pregnancy

Pregnancy Category Explanation
All Trimesters B Animal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast Feeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving ondansetron, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ondansetron with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Amifampridine
  • Apomorphine
  • Cisapride
  • Dronedarone
  • Fluconazole
  • Ketoconazole
  • Mesoridazine
  • Nelfinavir
  • Pimozide
  • Piperaquine
  • Posaconazole
  • Saquinavir
  • Sparfloxacin
  • Terfenadine
  • Thioridazine
  • Ziprasidone

Using ondansetron with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acecainide
  • Alfuzosin
  • Amiodarone
  • Amitriptyline
  • Amoxapine
  • Anagrelide
  • Arsenic Trioxide
  • Asenapine
  • Astemizole
  • Atazanavir
  • Azimilide
  • Azithromycin
  • Bedaquiline
  • Bepridil
  • Bretylium
  • Bupropion
  • Carbamazepine
  • Ceritinib
  • Chloroquine
  • Chlorpromazine
  • Ciprofloxacin
  • Citalopram
  • Clarithromycin
  • Clomipramine
  • Crizotinib
  • Cyclobenzaprine
  • Dabrafenib
  • Dasatinib
  • Deferasirox
  • Delamanid
  • Desipramine
  • Disopyramide
  • Dofetilide
  • Dolasetron
  • Domperidone
  • Doxepin
  • Droperidol
  • Ebastine
  • Enflurane
  • Eribulin
  • Erythromycin
  • Escitalopram
  • Eslicarbazepine Acetate
  • Famotidine
  • Felbamate
  • Fingolimod
  • Flecainide
  • Fluoxetine
  • Formoterol
  • Foscarnet
  • Fosphenytoin
  • Galantamine
  • Gatifloxacin
  • Gemifloxacin
  • Granisetron
  • Halofantrine
  • Haloperidol
  • Halothane
  • Hydroquinidine
  • Ibutilide
  • Iloperidone
  • Imipramine
  • Isoflurane
  • Isradipine
  • Itraconazole
  • Ivabradine
  • Lapatinib
  • Levofloxacin
  • Lopinavir
  • Lumefantrine
  • Mefloquine
  • Methadone
  • Mifepristone
  • Mitotane
  • Mizolastine
  • Moxifloxacin
  • Nilotinib
  • Norfloxacin
  • Nortriptyline
  • Octreotide
  • Ofloxacin
  • Olanzapine
  • Paliperidone
  • Paroxetine
  • Pasireotide
  • Pazopanib
  • Pentamidine
  • Perflutren Lipid Microsphere
  • Perphenazine
  • Pixantrone
  • Primidone
  • Probucol
  • Procainamide
  • Prochlorperazine
  • Promethazine
  • Propafenone
  • Protriptyline
  • Quetiapine
  • Quinidine
  • Quinine
  • Ranolazine
  • Rilpivirine
  • Risperidone
  • Ritonavir
  • Salmeterol
  • Sematilide
  • Sertindole
  • Sertraline
  • Sevoflurane
  • Siltuximab
  • Sodium Phosphate
  • Sodium Phosphate, Dibasic
  • Sodium Phosphate, Monobasic
  • Solifenacin
  • Sorafenib
  • Sotalol
  • Sunitinib
  • Tacrolimus
  • Tamoxifen
  • Tedisamil
  • Telavancin
  • Telithromycin
  • Tetrabenazine
  • Tizanidine
  • Tolterodine
  • Toremifene
  • Trazodone
  • Trifluoperazine
  • Trimipramine
  • Vandetanib
  • Vardenafil
  • Vemurafenib
  • Venlafaxine
  • Vilanterol
  • Vinflunine
  • Voriconazole
  • Vorinostat

Using ondansetron with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Cyclophosphamide

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using ondansetron with any of the following is usually not recommended, but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use ondansetron, or give you special instructions about the use of food, alcohol, or tobacco.

  • Tobacco

Other Medical Problems

The presence of other medical problems may affect the use of ondansetron. Make sure you tell your doctor if you have any other medical problems, especially:

  • Allergy to selective 5-HT3 receptor antagonists (such as alosetron [Lotronex®], dolasetron [Anzemet®], granisetron [Kytril®], or palonosetron [Aloxi®])—Use with caution. It is likely you will also be allergic to ondansetron.
  • Bowel blockage or
  • Gastric distension (enlarged abdomen)—May cover up symptoms of these stomach or bowel problems, especially in patients who had a recent abdominal or stomach surgery.
  • Bradyarrhythmia (slow heartbeat) or
  • Congestive heart failure or
  • Electrolyte imbalance (e.g., low potassium or magnesium in the blood)—Patients with these conditions should be monitored while using ondansetron.
  • Heart rhythm problems (e.g., congenital long QT syndrome, Torsade de Pointes)—Use is not recommended in patients with this condition.
  • Heart rhythm problems (e.g., prolonged QT interval)—Use with caution. May make this condition worse.
  • Liver disease—Use with caution. The effects may be increased because of slower removal of the medicine from the body.

Proper Use of ondansetron

A nurse or other trained health professional will give you or your child ondansetron in a hospital or cancer treatment center. ondansetron is given as a shot into a muscle or a vein.

When ondansetron is used to prevent nausea and vomiting caused by cancer medicines (chemotherapy), it is usually given 30 minutes before the start of chemotherapy. Additional doses may be given 4 hours after the first dose and 8 hours after the first dose.

When ondansetron is used to prevent nausea and vomiting caused by surgery, it is usually given just before anesthesia (medicine to put you to sleep before surgery) or right after surgery if nausea and vomiting begin.

Your doctor will give you a few doses of ondansetron until your condition improves, and then switch you to an oral medicine that works the same way. If you have any concerns about this, talk to your doctor.

Precautions While Using ondansetron

Check with your doctor if severe nausea and vomiting continue after leaving the hospital or cancer treatment center.

ondansetron may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Call your doctor right away if you or your child have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after you receive the medicine.

Do not use ondansetron if you or your child are receiving apomorphine (Apokyn®). Using these medicines together may cause serious side effects.

ondansetron can cause changes in heart rhythms, such as a condition called QT prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you or your child have any symptoms of heart rhythm problems, such as fast, pounding, or irregular heartbeats.

Check with your doctor right away if you or your child start to have pain or swelling in your stomach area. These may be signs of a serious stomach or bowel problem.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

ondansetron Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Rare
  • Chest pain or discomfort
  • pain, redness, or burning at the injection site
  • shortness of breath
  • skin rash, hives, redness, or itching
  • tightness in the chest
  • troubled breathing
  • wheezing
Incidence not known
  • Blurred vision
  • cold, clammy skin
  • confusion
  • coughing
  • decreased or irregular heartbeat
  • difficulty with breathing or swallowing
  • dizziness or fainting
  • dizziness, faintness, or lightheadedness when getting up from a lying position
  • fast, pounding, slow, or irregular heartbeat or pulse
  • fast, weak pulse
  • fixed position of the eye
  • heart stops
  • hives or welts
  • hoarseness
  • inability to move the eyes
  • increased blinking or spasms of the eyelid
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • lightheadedness
  • no breathing
  • no pulse or blood pressure
  • noisy breathing
  • pain in the neck, back, or jaw
  • slow or irregular breathing
  • sticking out of the tongue
  • sweating
  • swelling of the face, throat, or tongue
  • trouble with breathing, speaking, or swallowing
  • unconscious
  • uncontrolled twisting movements of the neck, trunk, arms, or legs
  • unusual facial expressions
  • weakness
  • weakness of the arms and legs

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Constipation
  • diarrhea
  • fever
  • headache
Less common
  • Abdominal or stomach pain or cramps
  • burning, tingling, or prickling sensations
  • drowsiness
  • dryness of the mouth
  • feeling cold
  • itching
  • unusual tiredness or weakness

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

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