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Ondansetron blocks the actions of chemicals in the body that can trigger nausea and vomiting.
Ondansetron is used to prevent nausea and vomiting that may be caused by surgery, cancer chemotherapy, or radiation treatment.
Ondansetron may be used for purposes not listed in this medication guide.
You should not use ondansetron if you are also using apomorphine (Apokyn).
You should not use ondansetron if you are allergic to it or to similar medicines such as dolasetron (Anzemet), granisetron (Kytril), or palonosetron (Aloxi).
Before taking ondansetron, tell your doctor if you have liver disease, or a personal or family history of Long QT syndrome.
Ondansetron orally disintegrating tablets may contain phenylalanine. Tell your doctor if you have phenylketonuria (PKU).
Serious side effects of ondansetron include blurred vision or temporary vision loss (lasting from only a few minutes to several hours), slow heart rate, trouble breathing, anxiety, agitation, shivering, feeling like you might pass out, and urinating less than usual or not at all. Stop taking this medicine and call your doctor at once if you have any of these side effects. Ondansetron may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
You should not use ondansetron if:
you are also using apomorphine (Apokyn); or
you are allergic to ondansetron or similar medicines (dolasetron, granisetron, palonosetron).
To make sure ondansetron is safe for you, tell your doctor if you have:
liver disease;
an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
congestive heart failure, slow heartbeats;
a personal or family history of long QT syndrome; or
a blockage in your digestive tract (stomach or intestines).
Ondansetron is not expected to harm an unborn baby. Tell your doctor if you are pregnant.
It is not known whether ondansetron passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Ondansetron is not approved for use by anyone younger than 4 years old.
Ondansetron orally disintegrating tablets may contain phenylalanine. Tell your doctor if you have phenylketonuria (PKU).
Take ondansetron exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smaller amounts or for longer than recommended.
Ondansetron can be taken with or without food.
The first dose is usually taken before the start of your surgery, chemotherapy, or radiation treatment. Follow your doctor's dosing instructions very carefully.
Take the ondansetron regular tablet with a full glass of water.
To take the orally disintegrating tablet (Zofran ODT):
Keep the tablet in its blister pack until you are ready to take it. Open the package and peel back the foil. Do not push a tablet through the foil or you may damage the tablet.
Use dry hands to remove the tablet and place it in your mouth.
Do not swallow the tablet whole. Allow it to dissolve in your mouth without chewing.
Swallow several times as the tablet dissolves.
To use ondansetron oral soluble film (strip) (Zuplenz):
Keep the strip in the foil pouch until you are ready to use the medicine.
Using dry hands, remove the strip and place it on your tongue. It will begin to dissolve right away.
Do not swallow the strip whole. Allow it to dissolve in your mouth without chewing.
Swallow several times after the strip dissolves. If desired, you may drink liquid to help swallow the dissolved strip.
Wash your hands after using Zuplenz.
Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
Store at room temperature away from moisture, heat, and light. Store liquid medicine in an upright position.
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
Overdose symptoms may include sudden loss of vision, severe constipation, feeling light-headed, or fainting.
Ondansetron may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
Get emergency medical help if you have signs of an allergic reaction to ondansetron: rash, hives; fever, chills, difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
severe constipation, stomach pain, or bloating;
headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
fast or pounding heartbeats;
jaundice (yellowing of the skin or eyes);
blurred vision or temporary vision loss (lasting from only a few minutes to several hours);
high levels of serotonin in the body--agitation, hallucinations, fever, fast heart rate, overactive reflexes, nausea, vomiting, diarrhea, loss of coordination, fainting.
Common ondansetron side effects may include:
diarrhea or constipation;
headache;
drowsiness; or
tired feeling.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Usual Adult Dose of Ondansetron for Nausea/Vomiting -- Chemotherapy Induced:
Oral:
Highly Emetogenic Cancer Chemotherapy (HEC):
-Recommended dose: 24 mg orally 30 minutes before the start of single-day HEC (including cisplatin doses of 50 mg/m2 or greater)
Moderately Emetogenic Cancer Chemotherapy (MEC):
-Recommended dose: 8 mg orally twice a day, with the first dose administered 30 minutes before the start of chemotherapy and the subsequent dose 8 hours later; then 8 mg orally 2 times a day (every 12 hours) for 1 to 2 days after the completion of chemotherapy
Parenteral:
-Recommended dose: 0.15 mg/kg IV, with the first dose (infused over 15 minutes) 30 minutes before the start of emetogenic chemotherapy and subsequent doses given 4 and 8 hours after the first dose.
-Maximum dose: 16 mg per dose
Comments:
-Multi-day, single-dose administration of 24 mg orally for HEC has not been studied.
-The injection formulation should be diluted prior to IV administration.
Uses:
-Prevention of nausea and vomiting associated with HEC or MEC
-Prevention of nausea and vomiting associated with initial and repeat courses of emetogenic chemotherapy
Usual Adult Dose of Ondansetron for Nausea/Vomiting:
Oral:
Highly Emetogenic Cancer Chemotherapy (HEC):
-Recommended dose: 24 mg orally 30 minutes before the start of single-day HEC (including cisplatin doses of 50 mg/m2 or greater)
Moderately Emetogenic Cancer Chemotherapy (MEC):
-Recommended dose: 8 mg orally twice a day, with the first dose administered 30 minutes before the start of chemotherapy and the subsequent dose 8 hours later; then 8 mg orally 2 times a day (every 12 hours) for 1 to 2 days after the completion of chemotherapy
Parenteral:
-Recommended dose: 0.15 mg/kg IV, with the first dose (infused over 15 minutes) 30 minutes before the start of emetogenic chemotherapy and subsequent doses given 4 and 8 hours after the first dose.
-Maximum dose: 16 mg per dose
Comments:
-Multi-day, single-dose administration of 24 mg orally for HEC has not been studied.
-The injection formulation should be diluted prior to IV administration.
Uses:
-Prevention of nausea and vomiting associated with HEC or MEC
-Prevention of nausea and vomiting associated with initial and repeat courses of emetogenic chemotherapy
Usual Adult Dose of Ondansetron for Nausea/Vomiting -- Postoperative:
Oral:
-Recommended dose: 16 mg orally 1 hour before the induction of anesthesia
Parenteral:
-Recommended dose: 4 mg IV (undiluted) immediately before induction of anesthesia or postoperatively (nausea and/or vomiting within 2 hours after surgery)
-Alternative route: 4 mg IM (undiluted)
Comment:
-Administration of a second dose does not provide additional control of nausea and vomiting.
Use:
-Prevention of postoperative nausea and vomiting
Usual Adult Dose for Nausea/Vomiting--Radiation Induced:
Recommended dose: 8 mg orally 3 times a day
-Total Body Irradiation: 8 mg orally 1 to 2 hours before each fraction of radiotherapy administered each day
-Single High-dose Fraction Radiotherapy to the Abdomen: 8 mg orally 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for 1 to 2 days after the completion of radiotherapy
-Daily Fractionated Radiotherapy to the Abdomen: 8 mg orally 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for each day radiotherapy is given
Use:
-Prevention of nausea and vomiting associated with radiotherapy, either as total body irradiation, single high-dose fraction, or daily fractions to the abdomen
Usual Pediatric Dose for Nausea/Vomiting -- Postoperative:
Parenteral:
1 month to 12 years:
Less than 40 kg:
-Recommended dose: 0.1 mg/kg IV over 2 to 5 minutes immediately prior to/following anesthesia induction or postoperatively (nausea and/or vomiting occurring shortly after surgery)
40 kg and greater:
-Recommended dose: 4 mg IV over 2 to 5 minutes immediately prior to/following anesthesia induction or postoperatively (nausea and/or vomiting occurring shortly after surgery)
Use:
-Prevention of postoperative nausea and vomiting
Usual Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:
Oral:
4 to 11 years:
-Recommended dose: 4 mg orally 3 times a day, with the first dose administered 30 minutes before the start of chemotherapy, and subsequent doses 4 and 8 hours after the first dose; then 4 mg orally 3 times a day (every 8 hours) for 1 to 2 days after the completion of chemotherapy
12 years and older:
-Recommended dose: 8 mg orally twice a day, with the first dose administered 30 minutes before the start of chemotherapy and the subsequent dose 8 hours later; then 8 mg orally 2 times a day (every 12 hours) for 1 to 2 days after the completion of chemotherapy
Parenteral:
6 months to 18 years:
-Recommended dose: 0.15 mg/kg IV, with the first dose (infused over 15 minutes) 30 minutes before the start of emetogenic chemotherapy, and subsequent doses given 4 and 8 hours after the first dose
-Maximum dose: 16 mg (per dose)
Comments:
-The injection formulation should be diluted in 50 mL prior to IV administration.
-This drug should be used to prevent nausea and vomiting associated with moderately to highly emetogenic chemotherapy.
Uses:
-Prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy
-Prevention of nausea and vomiting associated with initial and repeat courses of emetogenic chemotherapy
Ondansetron can cause a serious heart problem, especially if you use certain medicines at the same time, including antibiotics, antidepressants, heart rhythm medicine, antipsychotic medicines, and medicines to treat cancer, malaria, HIV or AIDS. Tell your doctor about all medicines you use, and those you start or stop using during your treatment with ondansetron.
Taking ondansetron while you are using certain other medicines can cause high levels of serotonin to build up in your body, a condition called "serotonin syndrome," which can be fatal. Tell your doctor if you also use:
medicine to treat depression;
medicine to treat a psychiatric disorder;
a narcotic (opioid) medication; or
medicine to prevent nausea and vomiting.
This list is not complete and many other drugs can interact with ondansetron. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
Further informationRemember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use ondansetron only for the indication prescribed.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Ondansetron Hcl (www.drugs.com/ondansetron.html).
Applies to ondansetron: film, solution, tablet, tablet disintegrating
Other dosage forms:
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
Less common
Rare
Incidence not known
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
Rare
Incidence not known
For Healthcare Professionals
Applies to ondansetron: injectable solution, intravenous solution, oral disintegrating strip, oral solution, oral tablet, oral tablet disintegrating
GeneralThe most frequently reported side effects are headache, constipation, and diarrhea.
Nervous systemVery 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
Dizziness occurred during rapid IV administration.
Headache occurred more often in the oral dissolving tablet formulation when taken with water.
OtherWound problems occurred at the surgical site in patients given this drug for the treatment of postoperative nausea and vomiting.
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
GastrointestinalVery 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
Localized anal/rectal burning occurred after insertion of the suppository formulation.
OcularOculogyric 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.
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
CardiovascularCardiopulmonary arrest and shock occurred during allergic reactions in patients given the IV formulation.
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
RespiratoryCommon (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
Laryngospasm occurred during allergic reactions in patients given the IV formulation.
PsychiatricCommon (1% to 10%): Anxiety/agitation, disturbance in behavior/conduct, sleep disturbance
GenitourinaryCommon (1% to 10%): Gynecological disorder, urinary retention, urinary tract infection/dysuria
DermatologicCommon (1% to 10%): Rash, pruritus
Very rare (less than 0.01%): Toxic skin eruption, toxic epidermal necrolysis
HepaticCommon (1% to 10%): Asymptomatic increases in AST/ALT
Postmarketing reports: Liver failure and death
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.
LocalCommon (1% to 10%): Injection site reactions
HypersensitivityRare (0.01% to 0.1%): Immediate hypersensitivity reactions (sometimes severe), anaphylaxis/anaphylactoid reactions
Postmarketing reports: Angioedema
MetabolicRare (0.01% to 0.1%): Hypokalemia
Frequency not reported: Poor oral intake
Medically reviewed by USARx EDITORIAL TEAM Last updated on 1/1/2020.
Source: Drugs.com Ondansetron Hcl (www.drugs.com/ondansetron.html).
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