Ondansetron Side Effects
Brand Names: Zofran, Zofran ODT
Please note - some side effects for Ondansetron may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA at http://www.fda.gov/medwatch/ or 1-800-FDA-1088 (1-800-332-1088).
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For the consumer For the professional
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Side Effects of Ondansetron - for the consumer
Ondansetron
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Ondansetron:
Seek medical attention right away if any of these SEVERE side effects occur when using Ondansetron:Constipation; diarrhea; dizziness; drowsiness; headache; irritation, redness, pain, or burning at the site of injection; tiredness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fever; skin tingling or numbness; trouble urinating; vision changes or loss.
Ondansetron Orally Disintegrating Tablets
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Ondansetron Orally Disintegrating Tablets:
Seek medical attention right away if any of these SEVERE side effects occur when using Ondansetron Orally Disintegrating Tablets:Constipation; diarrhea; dizziness; drowsiness; headache; tiredness; weakness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fever; skin tingling or numbness; trouble urinating; vision change or loss.
Ondansetron Solution
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Ondansetron Solution:
Seek medical attention right away if any of these SEVERE side effects occur when using Ondansetron Solution:Constipation; diarrhea; dizziness; drowsiness; headache; tiredness; weakness.
Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fever; skin tingling or numbness; trouble urinating; vision change or loss.
Ondansetron Tablets
All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome when using Ondansetron Tablets:
Seek medical attention right away if any of these SEVERE side effects occur when using Ondansetron Tablets:Constipation; diarrhea; dizziness; drowsiness; headache; tiredness; weakness.
TopSevere allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); chest pain; fever; skin tingling or numbness; trouble urinating; vision change or loss.
For the professional
Ondansetron
The following have been reported as adverse events in clinical trials of patients treated with Ondansetron, the active ingredient of Ondansetron hydrochloride tablets. A causal relationship to therapy with Ondansetron has been unclear in many cases.
Chemotherapy-Induced Nausea and Vomiting
The adverse events in Table 5 have been reported in ≥ 5% of adult patients receiving a single 24 mg Ondansetron hydrochloride tablet in 2 trials. These patients were receiving concurrent highly emetogenic cisplatin-based chemotherapy regimens (cisplatin dose ≥ 50 mg/m2).
| Event | Ondansetron 24 mg q.d. n = 300 | Ondansetron 8 mg b.i.d. n = 124 | Ondansetron 32 mg q.d. n = 117 |
| Headache | 33 (11%) | 16 (13%) | 17 (15%) |
| Diarrhea | 13 (4%) | 9 (7%) | 3 (3%) |
The adverse events in Table 6 have been reported in ≥ 5% of adults receiving either 8 mg of Ondansetron hydrochloride tablets 2 or 3 times a day for 3 days or placebo in 4 trials. These patients were receiving concurrent moderately emetogenic chemotherapy, primarily cyclophosphamide-based regimens.
| Event | Ondansetron 8 mg b.i.d. n = 242 | Ondansetron 8 mg t.i.d. n = 415 | Placebo n = 262 |
| Headache | 58 (24%) | 113 (27%) | 34 (13%) |
| Malaise/fatigue | 32 (13%) | 37 (9%) | 6 (2%) |
| Constipation | 22 (9%) | 26 (6%) | 1 (< 1%) |
| Diarrhea | 15 (6%) | 16 (4%) | 10 (4%) |
| Dizziness | 13 (5%) | 18 (4%) | 12 (5%) |
There have been rare reports consistent with, but not diagnostic of, extrapyramidal reactions in patients receiving Ondansetron.
HepaticIn 723 patients receiving cyclophosphamide-based chemotherapy in U.S. clinical trials, AST and/or ALT values have been reported to exceed twice the upper limit of normal in approximately 1% to 2% of patients receiving Ondansetron hydrochloride tablets. The increases were transient and did not appear to be related to dose or duration of therapy. On repeat exposure, similar transient elevations in transaminase values occurred in some courses, but symptomatic hepatic disease did not occur. The role of cancer chemotherapy in these biochemical changes cannot be clearly determined.
There have been reports of liver failure and death in patients with cancer receiving concurrent medications including potentially hepatotoxic cytotoxic chemotherapy and antibiotics. The etiology of the liver failure is unclear.
IntegumentaryRash has occurred in approximately 1% of patients receiving Ondansetron.
OtherRare cases of anaphylaxis, bronchospasm, tachycardia, angina (chest pain), hypokalemia, electrocardiographic alterations, vascular occlusive events, and grand mal seizures have been reported. Except for bronchospasm and anaphylaxis, the relationship to Ondansetron was unclear.
Radiation-Induced Nausea and Vomiting
The adverse events reported in patients receiving Ondansetron hydrochloride tablets and concurrent radiotherapy were similar to those reported in patients receiving Ondansetron hydrochloride tablets and concurrent chemotherapy. The most frequently reported adverse events were headache, constipation, and diarrhea.
Postoperative Nausea and Vomiting
The adverse events in Table 7 have been reported in ≥ 5% of patients receiving Ondansetron hydrochloride tablets at a dosage of 16 mg orally in clinical trials. With the exception of headache, rates of these events were not significantly different in the Ondansetron and placebo groups. These patients were receiving multiple concomitant perioperative and postoperative medications.
| Adverse Event | Ondansetron 16 mg (n = 550) | Placebo (n = 531) |
| Wound problem | 152 (28%) | 162 (31%) |
| Drowsiness/sedation | 112 (20%) | 122 (23%) |
| Headache | 49 (9%) | 27 (5%) |
| Hypoxia | 49 (9%) | 35 (7%) |
| Pyrexia | 45 (8%) | 34 (6%) |
| Dizziness | 36 (7%) | 34 (6%) |
| Gynecological disorder | 36 (7%) | 33 (6%) |
| Anxiety/agitation | 33 (6%) | 29 (5%) |
| Bradycardia | 32 (6%) | 30 (6%) |
| Shiver(s) | 28 (5%) | 30 (6%) |
| Urinary retention | 28 (5%) | 18 (3%) |
| Hypotension | 27 (5%) | 32 (6%) |
| Pruritus | 27 (5%) | 20 (4%) |
Observed During Clinical Practice
In addition to adverse events reported from clinical trials, the following events have been identified during post-approval use of oral formulations of Ondansetron. Because they are reported voluntarily from a population of unknown size, estimates of frequency cannot be made. The events have been chosen for inclusion due to a combination of their seriousness, frequency of reporting, or potential causal connection to Ondansetron.
CardiovascularRarely and predominantly with intravenous Ondansetron, transient ECG changes including QT interval prolongation have been reported.
GeneralFlushing. Rare cases of hypersensitivity reactions, sometimes severe (e.g., anaphylaxis/anaphylactoid reactions, angioedema, bronchospasm, shortness of breath, hypotension, laryngeal edema, stridor) have also been reported. Laryngospasm, shock, and cardiopulmonary arrest have occurred during allergic reactions in patients receiving injectable Ondansetron.
HepatobiliaryLiver enzyme abnormalities
Lower RespiratoryHiccups
NeurologyOculogyric crisis, appearing alone, as well as with other dystonic reactions
SkinUrticaria
Special SensesEye disorders
Cases of transient blindness, predominantly during intravenous administration, have been reported. These cases of transient blindness were reported to resolve within a few minutes up to 48 hours.
TopMore resources:
Zofran ODT Orally Disintegrating Tablets
Ondansetron - Includes detailed dosage instructions.
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