Generic Name: ondansetron (injection) (on DAN se tron)
Brand Names: Zofran
What is ondansetron?
Ondansetron blocks the actions of chemicals in the body that can trigger nausea and vomiting.
Ondansetron injection is used to prevent nausea and vomiting that may be caused by surgery or medicine to treat cancer (chemotherapy).
Ondansetron injection may also be used for purposes not listed in this medication guide.
What is the most important information I should know about ondansetron?
You should not use ondansetron if you are allergic to it, or if you are also using apomorphine (Apokyn). Ondansetron can cause serious heart rhythm problems. You should not use this medication if you have a history of Long QT syndrome. Tell your doctor if anyone in your family has ever had this condition.
Before receiving ondansetron injection, tell your doctor if you have liver disease, heart disease, a heart rhythm disorder, congestive heart failure, or low potassium or magnesium levels in your blood.
Tell your doctor about all other medicines you use. There are many other medicines that can increase your risk of heart rhythm problems if you use them together with ondansetron.
Call your doctor at once if you have fast, slow, or uneven heartbeats, or if you feel like you might pass out.
What should I discuss with my healthcare provider before taking ondansetron?
You should not use ondansetron if you are allergic to it, or if you are also using apomorphine (Apokyn). Ondansetron can cause serious heart rhythm problems. You should not use this medication if you have a history of Long QT syndrome. Tell your doctor if anyone in your family has ever had this condition.
To make sure you can safely receive ondansetron injection, tell your doctor if you have any of these other conditions:
liver disease;
a serious heart condition or heart rhythm disorder;
slow or fast heartbeats, or heart block;
congestive heart failure;
an electrolyte imbalance (such as low levels of potassium or magnesium in your blood); or
if you are allergic to medicines similar to ondansetron, such dolasetron (Anzemet), granisetron (Kytril), or palonosetron (Aloxi).
FDA pregnancy category B. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether ondansetron passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
How should I take ondansetron?
Ondansetron is injected into a vein through an IV. You will receive this injection in a clinic or hospital setting. Ondansetron must be given slowly, and the IV infusion can take up to 15 minutes to complete.
Ondansetron is usually given just before your surgery begins, or within 2 hours after surgery.
To prevent nausea and vomiting caused by chemotherapy, ondansetron is given 30 minutes before the start of chemotherapy. A second and third dose of ondansetron are sometimes given 4 hours and 8 hours after the first dose.
Ondansetron injection is not for preventing nausea or vomiting that is caused by factors other than chemotherapy or surgery.
See also: Ondansetron dosage (in more detail)
What happens if I miss a dose?
Since ondansetron is given by a healthcare professional, you are not likely to miss a dose.
What happens if I overdose?
Since this medication is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.
What should I avoid while taking ondansetron?
This medication may cause blurred vision and may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert and able to see clearly.
Ondansetron side effects
Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have a serious side effect such as:
fast, slow, or uneven heartbeats;
feeling like you might pass out;
headache with chest pain and severe dizziness, fainting, fast or pounding heartbeats;
Less serious side effects may include:
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.
Ondansetron Dosing Information
Usual Adult Dose for Nausea/Vomiting -- Chemotherapy Induced:
Initial: 0.15 mg/kg IV given 30 minutes before the start of emetogenic therapy, then repeat the dose at 4 hour intervals for 2 additional doses. A continuous IV dose option consists of 8 mg followed by 1 mg/hr for the next 24 hours.
Alternative therapies:
With highly emetogenic chemotherapy, give a onetime IV dose of 32 mg, 30 minutes before the start of single-day therapy; Infuse over 15 minutes. Alternatively, give a single 24 mg orally 30 minutes before therapy.
With moderate emetogenic chemotherapy, give 8 mg orally 30 minutes before the start of therapy, then 8 mg given 8 hours after the first dose. Thereafter, give 8 mg every 12 hours for 1 to 2 days after emetogenic therapy is complete.
Oral soluble film dosage form: Highly emetogenic cancer chemotherapy: 24 mg given successively as three 8 mg films administered 30 minutes before the start of single-day highly emetogenic chemotherapy, including cisplatin greater than or equal to 50 mg/m2. Moderately emetogenic cancer chemotherapy: One 8 mg soluble film given 2 times a day. The first dose should be administered 30 minutes before the start of emetogenic chemotherapy, with a subsequent dose 8 hours after the first dose.
Usual Adult Dose for Nausea/Vomiting:
Initial: 0.15 mg/kg IV given 30 minutes before the start of emetogenic therapy, then repeat the dose at 4 hour intervals for 2 additional doses. A continuous IV dose option consists of 8 mg followed by 1 mg/hr for the next 24 hours.
Alternative therapies:
With highly emetogenic chemotherapy, give a onetime IV dose of 32 mg, 30 minutes before the start of single-day therapy; Infuse over 15 minutes. Alternatively, give a single 24 mg orally 30 minutes before therapy.
With moderate emetogenic chemotherapy, give 8 mg orally 30 minutes before the start of therapy, then 8 mg given 8 hours after the first dose. Thereafter, give 8 mg every 12 hours for 1 to 2 days after emetogenic therapy is complete.
Oral soluble film dosage form: Highly emetogenic cancer chemotherapy: 24 mg given successively as three 8 mg films administered 30 minutes before the start of single-day highly emetogenic chemotherapy, including cisplatin greater than or equal to 50 mg/m2. Moderately emetogenic cancer chemotherapy: One 8 mg soluble film given 2 times a day. The first dose should be administered 30 minutes before the start of emetogenic chemotherapy, with a subsequent dose 8 hours after the first dose.
Usual Adult Dose for Nausea/Vomiting -- Postoperative:
4 mg IV (undiluted) over 2 to 5 minutes, or IM, immediately before induction of anesthesia or postoperatively if nausea or vomiting occurs immediately after surgery. Alternatively, 16 mg orally 1 hour before induction of anesthesia.
Oral soluble film dosage form: 16 mg given as successively as two 8 mg oral soluble films 1 hour before induction of anesthesia.
Usual Adult Dose for Nausea/Vomiting--Radiation Induced:
8 mg orally every 8 hours, give the first dose 1 to 2 hours prior to radiotherapy.
Oral soluble film dosage form:
One 8 mg soluble film given 3 times a day.
For total body irradiation: One 8 mg soluble film given 1 to 2 hours before each fraction of radiotherapy administered each day.
For single high-dose fraction radiotherapy to the abdomen: One 8 mg oral soluble film given 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for 1 to 2 days after completion of radiotherapy.
For daily fractionated radiotherapy to the abdomen: One 8 mg oral soluble film given 1 to 2 hours before radiotherapy, with subsequent doses every 8 hours after the first dose for each day radiotherapy is given.
Usual Adult Dose for Pruritus:
Study (n=150) - Induced by Intrathecal Fentanyl
8 mg IV before spinal anesthesia.
Usual Adult Dose for Alcohol Dependence:
Study (n=321) - Early onset alcoholism
4 mcg/kg two times daily.
Usual Adult Dose for Postanesthetic Shivering:
Study (n=82)
8 mg IV, 3 to 5 minutes before the induction of anesthesia.
Usual Pediatric Dose for Nausea/Vomiting -- Postoperative:
Child 1 month to 12 years:
40 kg or less: 0.1 mg/kg single dose IV, administered over 2 to 5 minutes, immediately prior to or following anesthesia induction, or postoperatively if nausea and/or vomiting present shortly after surgery.
40 kg or more: 4 mg single dose IV, administered over 2 to 5 minutes, immediately prior to or following anesthesia induction, or postoperatively if nausea and/or vomiting present shortly after surgery.
Usual Pediatric Dose for Nausea/Vomiting -- Chemotherapy Induced:
Child 6 months to 18 years: 0.15 mg/kg as an IV infusion (over 15 minutes) administered 30 minutes before the start of emetogenic therapy, then at 4 and 8 hours after the first dose, respectively.
4 to 11 years: 4 mg orally given 30 minutes before the start of emetogenic therapy, then 4 mg orally 4 and 8 hours after the first dose. Thereafter, 4 mg orally every 8 hours for 1 to 2 days after emetogenic therapy is complete.
11 years or older:: 8 mg orally 3 times daily, or 24 mg orally once daily.
Oral soluble film dosage form: Use of ondansetron oral soluble films is not indicated for treatment of nausea and vomiting associated with highly emetogenic cancer chemotherapy in pediatric patients.
For prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy: For pediatric patients 12 years of age and older, the dosage is the same as for adults. For pediatric patients 4 through 11 years of age, the dosage is one 4 mg oral soluble film given 3 times a day. The first dose should be administered 30 minutes before the start of emetogenic chemotherapy, with subsequent doses 4 and 8 hours after the first dose. One 4 mg oral soluble film should be administered 3 times a day (every 8 hours) for 1 to 2 days after completion of chemotherapy.
Usual Pediatric Dose for Gastroenteritis:
Study (n=145) - Control of emesis during the ED phase of oral rehydration:
6 months to 12 months: 1.6 mg orally every 8 hours
1 year to 3 years: 3.2 mg orally every 8 hours
4 years or older: 4 mg orally every 8 hours
Dosage was administered 15 minutes before the start of oral rehydration.
What other drugs will affect ondansetron?
There are many other medicines that can increase your risk of heart rhythm problems if you use them together with ondansetron.
Tell your doctor about all other medicines you use, especially:
arsenic trioxide (Trisenox);
tacrolimus (Prograf);
tramadol (Ultram);
an antibiotic such as clarithromycin (Biaxin), erythromycin (E.E.S., EryPed, Ery-Tab, Erythrocin, Pediazole), levofloxacin (Levaquin), moxifloxacin (Avelox), or pentamidine (NebuPent, Pentam);
an antidepressant such as amitriptyline (Elavil, Vanatrip, Limbitrol), clomipramine (Anafranil), or desipramine (Norpramin);
anti-malaria medications such as chloroquine (Aralen) or mefloquine (Lariam);
heart rhythm medicine such as amiodarone (Cordarone, Pacerone), dofetilide (Tikosyn), disopyramide (Norpace), dronedarone (Multaq), ibutilide (Corvert), procainamide (Procan, Pronestyl), propafenone (Rythmol), quinidine (Quin-G), or sotalol (Betapace);
other medicines to prevent or treat nausea and vomiting such as dolasetron (Anzemet) or droperidol (Inapsine);
medicines to treat psychiatric disorders, such as chlorpromazine (Thorazine), clozapine (FazaClo, Clozaril), haloperidol (Haldol), pimozide (Orap), thioridazine (Mellaril), or ziprasidone (Geodon);
migraine headache medicine such as sumatriptan (Imitrex, Treximet) or zolmitriptan (Zomig); or
narcotic medication such as methadone (Methadose, Diskets, Dolophine).
This list is not complete and other drugs may interact with ondansetron injection. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
More ondansetron resources
- Ondansetron Side Effects (in more detail)
- Ondansetron Dosage
- Ondansetron Use in Pregnancy & Breastfeeding
- Drug Images
- Ondansetron Drug Interactions
- Ondansetron Support Group
- 81 Reviews for Ondansetron - Add your own review/rating
Compare ondansetron with other medications
- Alcohol Dependence
- Gastroenteritis
- Nausea/Vomiting
- Nausea/Vomiting, Chemotherapy Induced
- Nausea/Vomiting, Postoperative
- Nausea/Vomiting, Radiation Induced
- Obsessive Compulsive Disorder
- Postanesthetic Shivering
- Pruritus
Where can I get more information?
- Your doctor or pharmacist can provide more information about ondansetron injection.
See also: ondansetron side effects (in more detail)
