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Ondansetron

DRUG STATUS

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Government Approvals

US(FDA), UK(BNF)

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WHO Essential Medicine

YES

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Known Teratogen

Unlisted

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Pharmaceutical Class

Serotonin-3 Receptor Antagonist

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Drug Ingredient

Ondansetron

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Summary

  • Ondansetron is used to prevent and treat nausea and vomiting caused by chemotherapy, radiation therapy, surgery, or other medical conditions.

  • Ondansetron works by blocking serotonin, a chemical in your body that can trigger nausea and vomiting. It is taken orally and is primarily broken down in the liver.

  • For nausea and vomiting due to chemotherapy, the usual dose is 8 mg taken 30 minutes before chemotherapy, then every 8 hours for the next 1-2 days. For postoperative nausea and vomiting, a typical dose is 4 to 8 mg given before or after surgery. It's usually taken as a tablet or oral disintegrating tablet.

  • Common side effects of Ondansetron include headaches, constipation, or diarrhea. Rarely, it can cause serious problems like allergic reactions, heart rhythm problems, a condition called serotonin syndrome, heart problems, and hiding symptoms of a bowel blockage.

  • Ondansetron should not be taken if you're allergic to it or if you're taking a medicine called apomorphine. It can cause serious side effects such as severe allergic reactions, irregular heartbeat, serotonin syndrome, chest pain, and gut problems. If you experience any of these, stop taking the medicine and contact your doctor.

Indications and Purpose

What is Ondansetron used for?

Ondansetron is a medicine that helps stop nausea and vomiting. People get sick to their stomach from things like cancer treatment (chemo and radiation) or after surgery. This medicine makes those side effects less likely.

How does Ondansetron work?

Ondansetron is a medicine that stops nausea and vomiting. It works by blocking serotonin, a chemical in your body that can trigger these symptoms. It's taken by mouth, and most of it is broken down in your liver before it reaches your bloodstream. A small amount leaves your body unchanged in your pee. How well it works and how long it stays in your body differs depending on your age and gender; women absorb it faster and keep it longer than men, and older people process it more slowly. Taking more doesn't necessarily make it work better.

Is Ondansetron effective?

Ondansetron is a medicine that helps prevent nausea and vomiting caused by chemotherapy. Studies show it works better than a sugar pill (placebo). For strong chemotherapy drugs, a single, larger dose of ondansetron was very effective, with most patients not vomiting at all and not needing extra medicine. For less strong chemotherapy drugs, a smaller, twice-daily dose was still much better than a placebo at preventing vomiting.

How does one know if Ondansetron is working?

Studies test ondansetron's ability to stop nausea and vomiting caused by chemo. They compare it to a sugar pill (placebo) in patients getting chemo. Doctors count how many times people throw up. If fewer people taking ondansetron vomit, it shows the drug works.

Directions for Use

What is the usual dose of Ondansetron?

  • For nausea and vomiting due to chemotherapy: The usual dose is 8 mg taken 30 minutes before chemotherapy and then every 8 hours for the next 1-2 days.
  • For postoperative nausea and vomiting: A typical dose is 4 to 8 mg given before or after surgery.
  • The dose may vary based on your condition and doctor's instructions.

How do I take Ondansetron?

  • Ondansetron is usually taken as a tablet or oral disintegrating tablet.
  • It can also be administered as an injection or liquid depending on the prescribed form.
  • Follow your doctor’s instructions carefully.

For how long do I take Ondansetron?

  • The duration depends on your condition. It’s typically taken for a short time to manage nausea during chemotherapy, surgery, or radiation treatment.
  • For long-term or chronic conditions, follow your doctor’s specific recommendations

How long does it take for Ondansetron to start working?

Ondansetron is a medicine that helps prevent nausea and vomiting. How quickly it works and how much you need depends on how strong the nausea-causing treatment is and how you take the medicine. For some treatments, a smaller dose taken shortly before starting treatment is enough. For stronger treatments, a larger dose is better at preventing sickness.

How should I store Ondansetron?

Keep the liquid Ondansetron medicine in a cool place (between 68° and 77°F), away from sunlight. Keep the bottle upright in its box. The Ondansetron pills can be kept in the same temperature range, but it's okay if the temperature goes slightly higher or lower (between 59° and 86°F). Keep the pills away from sunlight, too.

Warnings and Precautions

Who should avoid taking Ondansetron?

Ondansetron is a medicine that can cause serious problems for some people. It shouldn't be taken if you're allergic to it. It's also dangerous to take with another medicine called apomorphine because it can cause dangerously low blood pressure and fainting. Serious side effects are rare but possible, including severe allergic reactions (like trouble breathing), an irregular heartbeat (that could be life-threatening), a condition called serotonin syndrome (which involves confusion and other symptoms), chest pain, and problems with your gut. Your doctor may need to monitor you closely if you take this medicine. If you experience any of these side effects, stop taking the medicine immediately and contact your doctor.

Can I take Ondansetron with other prescription drugs?

  • Ondansetron can interact with several medications, including:
    • Antidepressants (e.g., SSRIs)
    • Antiarrhythmic medications (e.g., amiodarone)
    • Antifungal medications (e.g., ketoconazole)
  • Always inform your doctor about all medications you're taking.

Can I take Ondansetron with vitamins or supplements?

Ondansetron doesn’t have significant interactions with most vitamins or supplements, but always check with your doctor about specific supplements you're taking.

Can Ondansetron be taken safely while pregnant?

Studies on whether the drug ondansetron is safe to take during pregnancy haven't given a clear answer. One big study found no problems, but other smaller studies showed mixed results, with some suggesting a possible link to certain birth defects like cleft lip/palate, especially if taken by mouth during the first three months of pregnancy. It's important to remember that many pregnancies naturally have birth defects or miscarriages (2-4% for defects, 15-20% for miscarriages), so it's hard to say for sure if ondansetron is the cause when these occur. More research is needed.

Can Ondansetron be taken safely while breastfeeding?

Ondansetron may pass into breast milk, but it is generally considered safe for breastfeeding in most cases. Consult your doctor before taking Ondansetron while breastfeeding.

Is Ondansetron safe for the elderly?

This medicine doesn't need a different dose for older people. But those over 75 might process it slower, meaning it stays in their body longer. We don't have enough information to know if it's safe and works well for people over 75.

Is it safe to exercise while taking Ondansetron?

There are generally no restrictions on exercise while taking Ondansetron, but if you feel dizzy or tired, it’s best to avoid strenuous activities until you are feeling better.

Is it safe to drink alcohol while taking Ondansetron?

It’s not recommended to drink alcohol while taking Ondansetron, as it may increase the sedative effects or interact with other medications.