Ondansetron, orally disintegrating tablet (Zofran ODT)

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GENERIC NAME: Ondansetron, orally disintegrating tablet

BRAND NAME: Zofran ODT

DRUG CLASS AND MECHANISM: Ondansetron is an oral medication used for treating nausea that is most often used to prevent nausea and vomiting caused by cancer chemotherapy. Chemotherapeutic agents increase secretion of serotonin which stimulates serotonin (5-HT3) receptors in the brain, causing nausea and vomiting. Ondansetron works by blocking serotonin (5-HT3) receptors, reducing the effect of increased serotonin. The FDA approved ondansetron orally disintegrating tablets in January 1999.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Orally disintegrating tablets are available in 4 and 8 mg in unit dose packs.

STORAGE: Ondansetron should be stored between 2 C and 30 C (36 F and 86 F).

PRESCRIBED FOR: Ondansetron is used to prevent nausea and vomiting due to chemotherapy, radiation, and post-surgery.

DOSING:

Adults

  • Highly nauseating chemotherapy: 24 mg orally dissolved on tongue 30 minutes prior to start of chemotherapy.
  • Moderately nauseating chemotherapy: 8 mg orally dissolved on tongue 30 minutes prior to chemotherapy and repeated in 8 hours, then 8 mg every 12 hours for 1 to 2 days after chemotherapy.
  • Radiation-induced nausea and vomiting: 8 mg orally dissolved on tongue 1 to 2 hours prior to radiation and every 8 hours after first dose, as needed.
  • Post-surgery nausea and vomiting: 16 mg orally dissolved on tongue 1 hour before anesthesia.

Children

  • Moderately nauseating chemotherapy (12 years and older) : 8 mg orally dissolved on tongue 30 minutes prior to chemotherapy and repeated in 8 hours, then 8 mg every 12 hours for 1 to 2 days after chemotherapy.
  • Moderately nauseating chemotherapy (4 to 11 years): 4 mg orally dissolved on tongue 30 minutes prior to chemotherapy and repeated in 4 and 8 hours after the first dose, then every 8 hours for 1 to 2 days after chemotherapy.

DRUG INTERACTIONS: Ondansetron and apomorphine should not be used together due to the possibility of sudden lowering of blood pressure and loss of consciousness.

Phenytoin (Dilantin), carbamazepine (Tegretol), and rifampin (Rifadin) can increase ondansetron elimination and decrease blood levels, possibly lowering the effects of ondansetron.

Dronedarone (Multaq)can increase blood levels of ondansetron by reducing its breakdown in the liver. This may increase side effects of ondansetron. This combination may also increase the risk of abnormal heart beats.

PREGNANCY: There are no adequate studies done on ondansetron to determine its safe and effective use in rel="dt" onclick="wmdTrack('embd-lnk');"pregnant women.

NURSING MOTHERS: It is not known whether ondansetron enters breast milk; therefore, it is best to be cautious before using it in nursing mothers.

SIDE EFFECTS: Side effects of ondansetron are headache, malaise, fatigue, drowsiness, constipation, dizziness, and diarrhea. Some individuals may develop abnormal heart rate and rhythm.

REFERENCES:

Micromedex Drug Information

Ondansetron ODT – FDA Prescribing Information


Last Editorial Review: 4/23/2014




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