Ondansetron Side Effects

Medically reviewed by Drugs.com. Last updated on Aug 6, 2023.

Applies to ondansetron: film, solution, tablet, tablet disintegrating. Other dosage forms:

injection solution

Serious side effects of Ondansetron

Along with its needed effects, ondansetron 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 immediately if any of the following side effects occur while taking ondansetron:

More common

Confusion
dizziness
fast heartbeat
fever
headache
trouble breathing

Less common

Decrease in the frequency of urination
decrease in the urine volume
difficulty with passing urine (dribbling)
painful urination

Rare

Arm, back, or jaw pain
chest pain, discomfort, tightness, or heaviness
cough
decreased urine
difficulty with breathing
difficulty with swallowing
dry mouth
fast, pounding, or irregular heartbeat or pulse
increased thirst
loss of appetite
loss of bladder control
loss of consciousness
mood changes
muscle pain or cramps
nausea or vomiting
noisy breathing
numbness or tingling in the hands, feet, or lips
puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
seizures
skin rash, hives, or itching
sweating
total body jerking
unusual tiredness or weakness

Incidence not known

Agitation
blistering, peeling, or loosening of the skin
blurred vision
chills
diarrhea
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
fixed position of the eye
heart stops
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
no pulse or blood pressure
noisy breathing
overactive reflexes
pain or discomfort in the arms, jaw, back, or neck
poor coordination
pounding heartbeat
red irritated eyes
red skin lesions often with a purple center
restlessness
shivering
slow or irregular breathing
sore throat
sores, ulcers, or white spots in the mouth or on the lips
sticking out of the tongue
sweating
talking or acting with excitement you cannot control
trembling or shaking
trouble with speaking
twitching
unconscious
uncontrolled twisting movements of the neck, trunk, arms, or legs
unusual facial expressions
vomiting

Other side effects of Ondansetron

Some side effects of ondansetron 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

Anxiety
difficulty having a bowel movement (stool)
dry mouth
general feeling of discomfort or illness
hyperventilation
irritability
shaking
trouble sleeping

Rare

Difficulty with speaking
drooling
loss of balance control
muscle trembling, jerking, or stiffness
shuffling walk
stiffness of the limbs
uncontrolled movements, especially of the face, neck, and back

Incidence not known

Feeling of warmth
hiccups
redness of the face, neck, arms, and occasionally, upper chest
redness of the skin

For Healthcare Professionals

Applies to ondansetron: injectable solution, intravenous solution, oral disintegrating strip, oral solution, oral tablet, oral tablet disintegrating.

General

The most frequently reported side effects are headache, constipation, and diarrhea.^[Ref]

Nervous system

Very common (10% or more): Headache (up to 27%), drowsiness/sedation (up to 23%)

Common (1% to 10%): Dizziness, paresthesia

Uncommon (0.1% to 1%): Seizures, movement disorders/extrapyramidal reactions (oculogyric crisis/dystonic reactions, dyskinesia)

Rare (0.01% to 0.1%): Grand mal seizures^[Ref]

Dizziness occurred during rapid IV administration.

Headache occurred more often in the oral dissolving tablet formulation when taken with water.^[Ref]

Other

Wound problems occurred at the surgical site in patients given this drug for the treatment of postoperative nausea and vomiting.^[Ref]

Very common (10% or more): Wound problem (up to 28%), malaise/fatigue (up to 13%)

Common (1% to 10%): Shivers, pyrexia/fever, cold sensation

Frequency not reported: Pain, ear disorder^[Ref]

Gastrointestinal

Very common (10% or more): Diarrhea (up to 16%), constipation (up to 11%)

Common (1% to 10%): Xerostomia, nausea, vomiting, localized anal/rectal burning sensation

Uncommon (0.1% to 1%): Throat disorder

Frequency not reported: Gastric symptoms, abdominal pain, flatulence^[Ref]

Localized anal/rectal burning occurred after insertion of the suppository formulation.^[Ref]

Ocular

Oculogyric crisis occurred alone and in combination with other dystonic reactions.

Transient visual disturbances, blurred vision, and transient blindness occurred predominantly during rapid IV administration. Many of the cases of blindness resolved from within a few minutes to approximately 28 hours. Most patients were receiving concomitant chemotherapy with cisplatin.^[Ref]

Very common (10% or more): Eye disorder (up to 19%)

Common (1% to 10%): Visual disturbance/transient visual disturbances (e.g., blurred vision)

Uncommon (0.1% to 1%): Oculogyric crisis

Very rare (less than 0.01%): Transient blindness

Frequency not reported: Swollen periocular area^[Ref]

Cardiovascular

Cardiopulmonary arrest and shock occurred during allergic reactions in patients given the IV formulation.^[Ref]

Common (1% to 10%): Sensation of warmth/flushing, bradycardia, hypotension, arrhythmias

Uncommon (0.1% to 1%): Chest pain with/without ST segment depression

Rare (0.01% to 0.1%): Transient ECG changes including QT interval prolongation (Torsade de Pointes), angina/chest pain, vascular occlusive events, tachycardia

Frequency not reported: Hemorrhage

Postmarketing reports: Cardiopulmonary arrest, shock^[Ref]

Respiratory

Common (1% to 10%): Hypoxia, lower respiratory tract disease, expectoration, cough

Uncommon (0.1% to 1%): Hiccups

Rare (0.01% to 0.1%): Bronchospasm/asthma

Postmarketing reports: Shortness of breath, laryngeal edema, stridor, laryngospasm^[Ref]

Laryngospasm occurred during allergic reactions in patients given the IV formulation.^[Ref]

Psychiatric

Common (1% to 10%): Anxiety/agitation, disturbance in behavior/conduct, sleep disturbance^[Ref]

Genitourinary

Common (1% to 10%): Gynecological disorder, urinary retention, urinary tract infection/dysuria^[Ref]

Dermatologic

Common (1% to 10%): Rash, pruritus

Very rare (less than 0.01%): Toxic skin eruption, toxic epidermal necrolysis^[Ref]

Hepatic

Common (1% to 10%): Asymptomatic increases in AST/ALT

Postmarketing reports: Liver failure and death^[Ref]

Transient, asymptomatic increases in AST/ALT 2 times the upper limit of normal commonly occurred in patients receiving chemotherapy with cisplatin, and did not appear to be related to dose/duration of treatment.

Liver failure and death have been reported in patients with cancer receiving potentially hepatotoxic/cytotoxic chemotherapy and antibiotics; however, the etiology of liver failure is unknown.^[Ref]