What are the primary uses of Zofran. How does ondansetron work to prevent nausea and vomiting. What are the potential side effects and precautions for using Zofran during pregnancy. How is Zofran administered and what are the recommended dosages.

Understanding Zofran: A Powerful Antiemetic Medication

Zofran, also known by its generic name ondansetron, is a medication that belongs to the class of 5-HT3 receptor antagonists. This potent antiemetic drug has gained significant attention in the medical community for its efficacy in preventing and treating nausea and vomiting associated with various conditions.

How Does Zofran Work?

Zofran works by reducing the effects of serotonin, a naturally occurring chemical in the body that can trigger nausea and vomiting. By blocking serotonin receptors in the gut and brain, ondansetron helps alleviate these unpleasant symptoms, providing relief to patients undergoing chemotherapy, radiation therapy, or recovering from surgery.

Primary Uses of Zofran: Beyond Chemotherapy-Induced Nausea

While Zofran is widely recognized for its use in managing chemotherapy-induced nausea and vomiting, its applications extend beyond oncology settings. Here are the primary uses of Zofran:

• Prevention of chemotherapy-induced nausea and vomiting
• Management of radiation therapy-related nausea
• Prevention and treatment of postoperative nausea and vomiting
• Off-label use for severe morning sickness during pregnancy (with caution)

Zofran in Cancer Treatment

For cancer patients undergoing chemotherapy or radiation therapy, Zofran has proven to be a game-changer. It significantly improves the quality of life by reducing the incidence and severity of nausea and vomiting, allowing patients to better tolerate their treatment regimens.

Zofran Formulations and Administration

Zofran is available in various formulations to suit different patient needs and clinical situations. The commonly available forms include:

• Tablets (4 mg and 8 mg)
• Oral solution (4 mg/5 mL)
• Orally disintegrating tablets (ODT)
• Injectable solution for intravenous use (2 mg/mL)

Dosage Guidelines

The appropriate dosage of Zofran varies depending on the indication and patient characteristics. Typically, for chemotherapy-induced nausea and vomiting, adults may receive 8 mg orally or intravenously before treatment, followed by additional doses as needed. For postoperative nausea and vomiting, a single 4 mg dose is often sufficient.

Side Effects and Precautions: What Patients Should Know

While Zofran is generally well-tolerated, it’s essential for patients to be aware of potential side effects. Common side effects may include:

• Headache
• Constipation
• Fatigue
• Dizziness

In rare cases, more serious side effects can occur, such as allergic reactions or changes in heart rhythm. Patients should promptly report any unusual symptoms to their healthcare provider.

Drug Interactions

Zofran may interact with certain medications, including some antidepressants and heart medications. It’s crucial for patients to inform their healthcare providers about all medications they are taking to avoid potential interactions.

Zofran and Pregnancy: Navigating the Complexities

The use of Zofran during pregnancy has been a topic of discussion and research in recent years. While it is not officially approved for use in pregnancy, some healthcare providers prescribe it off-label for severe morning sickness or hyperemesis gravidarum.

Pregnancy Category and Recommendations

According to the FDA pregnancy category system, Zofran is classified as Category B, indicating that animal studies have not shown a risk to the fetus, but there are no adequate and well-controlled studies in pregnant women. The Australian TGA categorizes it as B1, suggesting limited use in pregnant women without observed harmful effects on the fetus.

Despite these classifications, the use of Zofran during pregnancy remains controversial. Current recommendations suggest:

• Use only if clearly needed (US guidelines)
• Not recommended (Australian and UK guidelines)
• Exercise caution, especially during the first trimester

Potential Risks and Benefits

While some studies have suggested a potential link between Zofran use and birth defects, particularly heart defects and cleft palate, the evidence is not conclusive. The decision to use Zofran during pregnancy should be made on a case-by-case basis, weighing the potential benefits against the risks.

Breastfeeding Considerations: Weighing the Options

For nursing mothers, the use of Zofran requires careful consideration. While it’s unknown whether ondansetron is excreted in human milk, animal studies have shown that it is present in animal milk. Current recommendations vary:

• Breastfeeding is not recommended during Zofran use (Australian and UK guidelines)
• Use with caution (US guidelines)

The effects on nursing infants are unknown, emphasizing the need for careful monitoring if Zofran is deemed necessary for a breastfeeding mother.

Zofran in Clinical Practice: Optimizing Patient Care

Healthcare providers play a crucial role in optimizing the use of Zofran for their patients. Here are some key considerations for clinical practice:

• Individualizing treatment plans based on patient characteristics and risk factors
• Monitoring for potential side effects and drug interactions
• Educating patients on proper administration and what to expect
• Considering alternative antiemetic options when appropriate

Combination Therapy

In some cases, Zofran may be used in combination with other antiemetic medications to provide more comprehensive nausea and vomiting control. This approach is particularly common in highly emetogenic chemotherapy regimens.

Future Directions: Research and Development

As our understanding of nausea and vomiting mechanisms evolves, so does the potential for improving antiemetic therapies. Ongoing research into Zofran and related medications focuses on:

• Developing new formulations for improved bioavailability
• Investigating long-term safety profiles
• Exploring potential new indications
• Enhancing our understanding of its effects during pregnancy

These research efforts aim to refine the use of Zofran and potentially develop even more effective and safer antiemetic options for patients in various clinical settings.

Patient Education: Empowering Informed Decision-Making

Effective patient education is crucial for the safe and successful use of Zofran. Healthcare providers should discuss the following points with their patients:

• Proper dosing and administration techniques
• Potential side effects and when to seek medical attention
• The importance of disclosing all medications and supplements being taken
• Special considerations for pregnant or breastfeeding women

By providing comprehensive information, healthcare providers can empower patients to make informed decisions about their treatment and ensure optimal outcomes.

Support Resources

Patients using Zofran, particularly those undergoing cancer treatment or experiencing severe pregnancy-related nausea, may benefit from additional support resources. These may include:

• Support groups for cancer patients or women with hyperemesis gravidarum
• Nutritional counseling to manage dietary challenges during treatment
• Psychological support to address the emotional impact of severe nausea and vomiting

Connecting patients with these resources can enhance their overall care experience and improve their quality of life while using Zofran.

Pharmacoeconomics: Balancing Efficacy and Cost

As healthcare systems worldwide grapple with rising costs, the pharmacoeconomic aspects of Zofran use have come under scrutiny. While the medication has proven highly effective in managing nausea and vomiting, its cost, particularly for brand-name formulations, can be substantial.

Generic Alternatives

The availability of generic ondansetron has significantly improved access to this medication. Healthcare providers and patients should discuss the options between brand-name Zofran and generic alternatives, considering factors such as:

• Cost differences
• Insurance coverage
• Potential variations in efficacy or side effects

In many cases, generic ondansetron can provide comparable benefits at a lower cost, making it a more accessible option for many patients.

Cost-Effectiveness Analysis

Several studies have examined the cost-effectiveness of Zofran in various clinical settings. For chemotherapy-induced nausea and vomiting, the use of Zofran has been shown to be cost-effective by reducing the need for additional medications, hospitalizations, and improving patient adherence to treatment regimens.

However, the off-label use of Zofran for pregnancy-related nausea remains a topic of debate from both clinical and economic perspectives. Healthcare systems must carefully weigh the potential benefits against the costs and risks associated with its use in this population.

Regulatory Landscape and Global Perspectives

The regulatory status and guidelines for Zofran use vary across different countries and regions. Understanding these differences is crucial for healthcare providers and patients, particularly in an increasingly globalized healthcare environment.

FDA Stance

In the United States, the FDA has approved Zofran for preventing nausea and vomiting associated with chemotherapy, radiation therapy, and surgery. However, it has not been approved for use in pregnancy-related nausea, despite its off-label use in this context.

European Medicines Agency (EMA) Perspective

The EMA’s stance on Zofran aligns closely with that of the FDA, approving its use for chemotherapy, radiation, and postoperative nausea and vomiting. The EMA has also issued cautionary statements regarding its use during pregnancy, emphasizing the need for careful consideration of risks and benefits.

Global Variations

Other countries may have different approaches to regulating and recommending Zofran use. For instance:

• In Canada, guidelines for off-label use in pregnancy are more permissive than in some other countries
• Australian guidelines are generally more conservative regarding its use during pregnancy and breastfeeding
• Some developing countries may have less stringent regulations or limited access to the medication

These global variations highlight the importance of staying informed about local regulations and guidelines when prescribing or using Zofran.

Ondansetron Use During Pregnancy | Drugs.com

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Medically reviewed by Drugs.com. Last updated on Oct 3, 2022.

Ondansetron is also known as: Zofran, Zofran ODT, Zuplenz

Ondansetron Pregnancy Warnings

Use is not recommended (AU, UK)
This drug should be used during pregnancy only if clearly needed (US)

AU TGA pregnancy category: B1
US FDA pregnancy category: B

Comment:
-If use is absolutely necessary, caution should be exercised, especially during the first trimester.

Animal studies have failed to reveal evidence of harm to the embryo, fetus, gestation period, perinatal/postnatal development, and/or fertility. There are no controlled data in human pregnancy.

AU TGA pregnancy category B1: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have not shown evidence of an increased occurrence of fetal damage.

US FDA pregnancy category B: Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women.

See references

Ondansetron Breastfeeding Warnings

Breastfeeding is not recommended during use of this drug (AU, UK)
Use with caution (US)

Excreted into human milk: Unknown
Excreted into animal milk: Yes

Comments: The effects in the nursing infant are unknown.

See references

See also

• Ondansetron use while Breastfeeding (in more detail)
• Ondansetron Consumer Information
• Pregnancy Support Group
• FDA Pregnancy Categories
• Medicine use during Pregnancy
• Medicine use while Breastfeeding
• Safe Medications during Breastfeeding

References for pregnancy information

1. Product Information. Zofran (ondansetron). GlaxoSmithKline. 2001.
2. Cerner Multum, Inc. UK Summary of Product Characteristics.
3. Cerner Multum, Inc. Australian Product Information.
4. Product Information. Zuplenz (ondansetron). Strativa Pharmaceuticals, a Division of Par Pharmaceuticals, Inc. 2010.

References for breastfeeding information

1. Product Information. Zofran (ondansetron). GlaxoSmithKline. 2001.
2. Cerner Multum, Inc. UK Summary of Product Characteristics.
3. Cerner Multum, Inc. Australian Product Information.
4. Product Information. Zuplenz (ondansetron). Strativa Pharmaceuticals, a Division of Par Pharmaceuticals, Inc. 2010.
5. United States National Library of Medicine. Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT 2013.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Zofran – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

Ondansetron belongs to the class of medications called 5-HT3 receptor antagonists.  This medication is used to prevent nausea and vomiting associated with certain types of cancer chemotherapy and radiation. It is also used to prevent and treat the nausea and vomiting that occurs after surgery. It works by reducing the effects of a naturally-occurring chemical in the body called serotonin, which causes nausea and vomiting.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Injection

Each mL contains ondansetron 2 mg/mL (as hydrochloride dihydrate) for IV use. Nonmedicinal ingredients: citric acid monohydrate, methyl- and propylparaben (vials only), sodium citrate, and sodium chloride.

Oral Solution

Each 5 mL contains ondansetron 4 mg (as hydrochloride dihydrate). Nonmedicinal ingredients: citric acid, sodium citrate dihydrate, sodium benzoate, sorbitol solution, and strawberry flavour. Sucrose-free. Sweetened with sorbitol.

Tablets

4 mg
Each oval-shaped, yellow, film-coated tablet, engraved “4” on one side and “GLAXO” on the other, contains ondansetron 4 mg (as hydrochloride dihydrate).  Nonmedicinal ingredients: lactose, magnesium stearate, hydroxypropyl methylcellulose, microcrystalline cellulose, opadry yellow or opaspray yellow (containing titanium dioxide and iron oxide yellow), and pregelatinized starch. Gluten- and tartrazine-free.

8 mg
Each oval-shaped, yellow, film-coated tablet, engraved “8” on one side and “GLAXO” on the other, contains ondansetron 8 mg (as hydrochloride dihydrate). Nonmedicinal ingredients: lactose, magnesium stearate, hydroxypropyl methylcellulose, microcrystalline cellulose, opadry yellow or opaspray yellow (containing titanium dioxide and iron oxide yellow), and pregelatinized starch. Gluten- and tartrazine-free.

Zofran ODT

4 mg
Each white, round, plano-convex, orally disintegrating tablet, with no markings on either side, contains ondansetron (base) 4 mg. Nonmedicinal ingredients: aspartame, gelatin, mannitol, sodium methyl hydroxybenzoate, sodium propyl hydroxybenzoate, and strawberry flavour.

8 mg
Each white, round, plano-convex, orally disintegrating tablet, with no markings on either side, contains ondansetron (base) 8 mg. Nonmedicinal ingredients: aspartame, gelatin, mannitol, sodium methyl hydroxybenzoate, sodium propyl hydroxybenzoate, and strawberry flavour.

How should I use this medication?

The recommended adult dose of ondansetron for nausea and vomiting caused by chemotherapy is based on severity of the symptoms and ranges from 8 mg to 24 mg daily given in divided doses.

Doses for children are based on body size. The recommended dose for children is 3 to 5 mg per square metre of body surface area and will be calculated by your doctor.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the one given here, do not change the way that you are taking the medication without consulting your doctor.

Ondansetron should be taken ½ to 1 hour before chemotherapy treatment. After this first dose, it should be taken every 8 to 12 hours for up to 5 days.

Use an oral syringe to measure each dose of the liquid, as it gives a more accurate measurement than household teaspoons.

Tablets should be swallowed whole, with fluids. Orally-dispersible tablets (ODTs) should be placed on the tongue and allowed to dissolve.

The recommended adult dose of ondansetron to treat and prevent nausea and vomiting caused by radiation therapy is 8 mg taken by mouth, 1 to 2 hours before treatment, and then every 8 hours for up to 5 days after treatment.

The recommended adult dose of ondansetron to prevent nausea and vomiting caused by surgery is 16 mg taken by mouth, 1 hour before anesthesia. Alternatively, a dose of 4 mg may be given by intravenous (into a vein) injection at the time of surgery. After surgery, a single dose of 4 mg of ondansetron may be given by intravenous injection to treat nausea or vomiting.

Ondansetron is not effective for treating or preventing nausea and vomiting caused by motion.

It is important to take this medication exactly as prescribed by your doctor. If you miss a dose, and you do not feel sick, skip the missed dose and continue with your regular schedule. If you miss a dose and feel sick or vomit, take it as soon as possible and continue with your regular schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store all forms of this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

• are allergic to ondansetron or any ingredients of the medication
• are taking the medication apomorphine

What side effects are possible with this medication?

Many medications can cause side effects.  A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• flushing or feeling warm
• hiccups
• low blood pressure
• unusual tiredness or weakness

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred vision
• difficulty moving or abnormal body movement
• dizziness
• pain, redness, or burning at place of injection
• signs of liver problems (e.g., nausea, vomiting, diarrhea, loss of appetite, weight loss, yellowing of the skin or whites of the eyes, dark urine, pale stools)
• signs of low potassium levels in the blood (e.g., weakness, fatigue, muscle cramps, irregular heartbeat)
• symptoms of irregular heartbeat (e.g., chest pain, dizziness, rapid, pounding heartbeat, shortness of breath)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• blindness
• seizures
• signs of a serious allergic reaction (i.e., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of heart problems (e. g., fast, irregular heartbeat or pulse, chest pain, sudden weight gain, difficulty breathing, leg swelling)
• signs of serotonin syndrome (e.g., agitation, confusion, mood changes, decreased coordination, hallucinations, fever, sweating)
• signs of a severe skin reaction (e.g., a rash combined with fever or discomfort, a rash covering a large area of the body, a rash that spreads quickly, blistering, peeling)
• signs of decreased blood flow to the heart muscle (e.g., chest pain or pressure, pain extending through shoulder and arm, nausea and vomiting, sweating)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Allergy: People who have had an allergic reaction to dolasetron or granisetron are advised not to take ondansetron. Before you take ondansetron, inform your doctor about any previous adverse reactions you have had to medications. Contact your doctor at once if you experience signs of an allergic reaction such as skin rash, itching, difficulty breathing, or swelling of the face and throat.

Abnormal heart rhythms: Very rarely, ondansetron can affect the heart’s electrical activity and cause an irregular heartbeat. This is more likely to happen with the injectable form of ondansetron. Certain medications (e.g., sotalol, quinidine, thioridazine, chlorpromazine, pimozide, moxifloxacin, mefloquine, pentamidine, arsenic trioxide, probucol, tacrolimus) can increase the risk of a type of abnormal heart rhythm called QT prolongation, and should not be used in combination with ondansetron. You are more at risk for this type of abnormal heart rhythm and its complications if you:

• are female
• are older than 65 years of age
• have a family history of sudden cardiac death
• have a history of heart disease or abnormal heart rhythms
• have a slow heart rate
• have congenital prolongation of the QT interval
• have diabetes
• have had a stroke
• have low potassium, magnesium, or calcium levels
• have nutritional deficiencies

If you have heart disease and abnormal heart rhythms, or are taking certain medications (e.g., verapamil, atazanavir), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. Your doctor may monitor your heart rate using a test called an electrocardiogram (ECG) while you are using this medication.

Heart problems: Ondansetron can cause blood vessels in the heart to spasm, reducing blood flow to parts of the heart. This can cause chest pain and in severe cases may cause areas of heart muscle to be damaged. If you experience chest pain, let your doctor know immediately.

Liver function: Ondansetron is broken down and removed from the body by the liver. Decreased liver function slows down the removal of the medication from the body and increases the risk of side effects from ondansetron. If you have liver disease or reduced liver function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Motion sickness: Ondansetron is not effective for the treatment of motion sickness.

Neuroleptic malignant syndrome (NMS): Ondansetron, like other similar medications, can cause a potentially fatal syndrome known as neuroleptic malignant syndrome (NMS). If you notice the symptoms of NMS such as high fever, muscle stiffness, confusion or loss of consciousness, sweating, racing or irregular heartbeat, or fainting, get immediate medical attention.

Phenylketonuria: People with phenylketonuria (lacking the enzyme needed to break down phenylalanine) should take forms of ondansetron other than oral dissolving tablets (ODT). The ODT form of ondansetron contains aspartame, an ingredient that cannot be broken down in the body by people who have phenylketonuria.

Serotonin syndrome: Severe reactions are possible when ondansetron is combined with other medications that act on serotonin, such as tricyclic antidepressants and serotonin reuptake inhibitors, medications used to treat depression. These combinations should be avoided. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, and changes in mental state including delirium and agitation. Coma and death are possible.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Use of ondansetron during the first trimester of pregnancy can increase the risk of birth defects. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: It is not known if ondansetron passes into breast milk. If you are breast-feeding and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication to treat nausea and vomiting caused by chemotherapy have not been established for children under 3 years of age. The safety and effectiveness of using this medication to treat nausea and vomiting caused by radiation or surgery have not been determined for children less than 18 years of age. Its use by this age group is not recommended.

Seniors: The safety and effectiveness of using this medication by people 65 years or older to treat nausea and vomiting caused by surgery have not been established. Seniors may be at an increased risk of developing irregular heartbeat with ondansetron, particularly the injectable form. Talk to your doctor about any concerns you may have.

What other drugs could interact with this medication?

There may be an interaction between ondansetron and any of the following:

• amiodarone
• antipsychotics (e.g., chlorpromazine, clozapine, haloperidol, olanzapine, pimozide, quetiapine, risperidone)
• apalutamide
• apomorphine
• carbamazepine
• capecitabine
• CF transmembrane regulators (e.g., ivacaftor, lumacaftor)
• disopyramide
• domperidone
• dronedarone
• enzalutamide
• fentanyl
• flecainide
• fluconazole
• linezolid
• lithium
• macrolide antibiotics (e.g., azithromycin, clarithromycin, erythromycin)
• meperidine
• metformin
• methadone
• mirtazapine
• monoamine oxidase inhibitors (MAOIs; e.g., moclobemide, phenelzine, tranylcypromine)
• phenobarbital
• phenytoin
• primidone
• procainamide
• propafenone
• quinine
• quinolone antibiotics (e. g., levofloxacin, moxifloxacin)
• rifampin
• St. John’s wort
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, paroxetine, sertraline, vortioxetine)
• serotonin/norepinephrine reuptake inhibitors (SNRIs; e.g., desvenlafaxine, duloxetine, venlafaxine)
• sotalol
• tapentadol
• tramadol
• trazodone
• tricyclic antidepressants (e.g., amitriptyline, clomipramine, desipramine, trimipramine)
• tryptophan
• tyrosine kinase inhibitors (e.g., crizotinib, dabrafenib, dasatinib, nilotinib, ribociclib, sunitinib)

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

All material copyright MediResource Inc. 1996 – 2023. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Zofran

Zofran instructions, price in pharmacies of Ukraine The drug contains the active component ondansetron, a selective blocker of serotonin 5HT3 receptors.

The drug may show an anti-diabetic effect. The mechanism of drug administration until the end of the term, it is therapeutically effective for the drug due to the influence of serotonin 5HT3 receptors in the central and peripheral nervous system, stimulation of these receptors during chemotherapy, which improves serotonin.

The drug does not have a sedative effect and does not affect plasma prolactin levels.

After oral administration, the drug is well absorbed in the intestinal tract. For ondansetron, the characteristic effect is the first passage through the liver. The peak plasma concentration of the active ingredient is observed 1.5 years after oral ingestion of the drug and 6 years after rectal ingestion. When taking the drug at once, the bioavailability of ondansetron is increased.

Metabolized in the liver, excreted most importantly in the presence of metabolites, about 5% of the drug is excreted in the unchanged form.

The period of administration of the drug is 3 years, in patients with a frail age – 5 years, after rectal ingestion of the drug – close to 6 years (as a result of greater absorption of the drug in the rectum). In patients with severe impairment of function, the period of drinking increases to 15-20 years.

The pharmacokinetics of the drug is the same for single and repeated doses.

In patients with impaired function, the systemic clearance and volume of distribution of the active ingredient are reduced. The period of administration in patients with impaired blood function and creatinine clearance of 15 to 60 ml / hv reaches 5.4 years.

In patients who are on hemodialysis, the pharmacokinetics of the drug are similar to those in patients with normal functioning of the drug.

In patients with severely impaired liver function, a decrease in systemic clearance of the active component of the drug, an increase in the period of administration (15-32 years) and oral bioavailability (100%) are indicated.

In women, systemic clearance and volume of ondansetron was lower, lower in humans.

Indication before congestion:

The drug is indicated for the treatment and prevention of vomiting in patients who are undergoing a course of cytostatic chemotherapy or radiotherapy.

The drug is also prescribed for the prevention and treatment of nausea and vomiting in patients who have undergone surgery. For the therapy of patients in the postoperative period, do not stop the drug Zofran in the form of suppositories.

Injection method:

Injection retailer

Prescription drug for parenteral infusion. The ampoule with the preparation should be taken out without delay before the infusion, in case, even though not all of the varieties are broken, I decide to dispose of it. Ready rozchin for infusion introduction is allowed to be taken at a temperature of 2 to 8 degrees Celsius for a duration of not more than 24 years. The drug in a dose of 8 mg and less is allowed to be administered intravenously, intravenously and at the same time as intravenous infusion. If the dose is higher than 8 mg, then the drug should be administered only in case of intravenous infusion. Intravenously, the drug should be injected regularly at the upper upper quadrant of the sydnychny m’yaza.

For the preparation of a brand for internal infusion as a retailer, a variety is allowed:

• 0.9% sodium chloride brand;
• Rozchin Ringer;
• 10% manitol;
• 5% glucose solution;
• 0.3% potassium chloride and 0.9% sodium chloride;
• 0.3% potassium chloride and 5% glucose. 0.9% sodium chloride, as well as the drug in other total sizes for intravenous administration is stable in polypropylene syringes.

  One-hour injection of a drug with a concentration of 16 to 160 µg / ml (8 mg / 500 ml and 8 mg / 50 ml) through a Y-shaped injector is allowed:

  • ia 0.48 mg / ml) for 1-8 years;
  • 5-fluorouracil (concentration 0.8 mg/ml) with a dose not exceeding 20 ml per year;
  • Carboplatin (concentration 0.18-9.9 mg / ml) with a stretch of 10-60 strands;
  • Etoposide (concentration 0.14-0.25 mg/ml) 30-60 strands;
  • Ceftazidime (dose 250-2000mg), administered in water for injection according to the recommended instructions, stretching 5 strands at a time of intravenous bolus injection;
  • Cyclophosphamide (dose 100-1000mg) is varied in water for injections according to the recommended instructions, with a stretch of 5 strands at the same time as an internal bolus injection;
  • Doxorubicin (dose 10-100mg) is administered in water for injections according to the recommended instructions, with a stretch of 5 strands at a glance for internal bolus injections;
  • The drug can also be mixed in a single urticaria with dexamethasone phosphate sodium sill (dose of ondansetron in a range of 8 µg/ml up to 1 mg/ml, dose of dexamethasone phosphate in a range of 32 µg/ml up to 2. 5 g/ml) entry hour 50- 100 ml rozchin not less than 15 quills.

  The validity of the course of treatment and the dose of the drug is determined by the drug individually for the skin patient.

  Older, if you are going to undergo a course of chemotherapy or radiotherapy, with nausea and vomiting, prescribe a proper injection of 8 mg of the drug before the start of therapy. In times like nudota or vomit, try for more than 24 years after the start of therapy, patients are prescribed the drug Zofran in medicinal forms for oral or rectal congestion.

  Let’s grow up, if you want to avoid therapy with highly methogenic drugs, in case of nausea and vomiting, prescribe a proper injection of 8 mg of the drug before chemotherapy. The dose of the drug should be increased as a fallow drug (maximum dose 32 mg) and administered as an intravenous infusion.

  In addition, during therapy with highly methogenic drugs, patients may be given the administration of ondansetron according to the regimen: 8 mg intravenously before chemotherapy, after which 2 repeated administrations of 8 mg of the drug with an interval of 2-4 godini. It is also possible to recognize ondansetron for intravenous infusion of 1 mg/year for 24 years.

  To improve the effectiveness of the drug, a single intravenous injection of 20 mg of dexamethasone phosphate sodium salt is given to current patients before chemotherapy on the cob.

  In times of nausea or vomiting, try for more than 24 years after the beginning of therapy, patients are prescribed the drug Zofran in medicinal forms for oral or rectal congestion.

  Children should be given an intravenous dose of 5 mg/m2 before chemotherapy. After 12 years after parenteral administration, the drug should be administered orally 4 mg of ondansetron 2 times a day. The oral form of the drug should be taken for 5 days after completion of the course of chemotherapy.

  Let’s grow up before the operative intervention for the prevention of nausea and vomit, administer 4 mg of the drug intravenously properly or internally during the period of induction anesthesia.

  For the treatment of vomiting in the postoperative period, it is necessary to prescribe a one-time intravenous injection of 4 mg of the drug.

  For children before surgery to prevent nausea and vomiting, prescribe the drug at a dose of 0.1 mg/kg of body weight intravenously properly during the period of induction anesthesia (it is also possible to introduce the drug before or after induction anesthesia).

  For the treatment of vomiting in the post-operative period, children should be given a one-time intravenous administration of the drug at a dose of 0.1 mg/kg body weight.

  The maximum dose of the drug for children with postoperative vomiting should be 4 mg of ondansetron.

  The maximum additional dose for the drug for patients who suffer from impaired liver function is 8 mg.

  Syrup, coated tablets, lingual tablets:

  Indication for oral administration. Tablets, covered with a shell, are recommended to be taken in whole, not rotting and not sagging, drinking down the necessary amount of water. Lingual tablets are recommended to be taken in the mouth empty until they are full (1-2 quills) after which they are swallowed. The syrup is recommended to be taken in an undiluted form, dosing the drug in the form of a syrup is carried out with the help of a special spoon, which is put into the pack at once with the bottle. The validity of the course of treatment and the dose of the drug depends on the drug individually for the skin patient.

  Older, if you want to take a course of chemotherapy or radiotherapy, with nausea and vomiting, prescribe 8 mg of the drug 1-2 years before the start of therapy. After which the drug is taken again after 12 years at a dose of 8 mg. For the prevention of piznyoї vomit, we grow up to sound, prescribe 8 mg of the drug 2 times a day. The drug should be taken for 5 days after completion of the course of chemotherapy or radiotherapy.

  Doroslimy, yakі otrimuyut therapy with highly methogenic drugs, with nausea and vomiting, prescribe 24 mg of the drug in combination with 12 mg of dexamethasone sodium sill phosphate 1-2 years before chemotherapy on the cob. For the prevention of vomit in 24 years after the first drug taken, you should prescribe 8 mg of ondansetron 2 times a day. The drug should be taken for 5 days after completion of the course of chemotherapy.

  Children should be given a parenteral drug before chemotherapy. After 12 years after parenteral administration, the drug should be administered orally 4 mg of ondansetron 2 times a day. The drug should be taken for 5 days after completion of the course of chemotherapy.

  Let’s grow up before the operative intervention for the prevention of nudity and vomit, you should prescribe 16 mg of the drug once 60 minutes before the ear of general anesthesia. For the treatment of vomiting in the postoperative period, it is recommended to stop the drug in the form of parenteral administration.

  Rectal suppositories:

  Prescription drug for rectal infusion. The validity of the course of treatment and the dose of the drug depends on the drug individually for the skin patient.

  Older, if you want to take a course of chemotherapy or radiotherapy, with nausea and vomiting, prescribe 1 suppository of the drug 1-2 years before the start of therapy. For the prevention of bloating in adulthood, prescribe 1 suppository of the drug 1 time per day.

  The preparation should be given for 5 days after completion of the course of chemotherapy or radiotherapy.

  As soon as possible, if you want to avoid therapy with highly methogenic drugs, in case of nausea and vomiting, prescribe 1 suppository of the drug 1-2 years before the start of chemotherapy. To enhance the therapeutic effect of the drug, a single intravenous injection of 20 mg of dexamethasone phosphate sodium salt is prescribed before chemotherapy on the cob.

  Let’s grow up for the prevention of vomiting in 24 years after the first drug taken, prescribe 1 suppository of the drug 1 time per day. The preparation should be taken for 5 days after completion of the course of chemotherapy.

  Antiemetics – veterinary articles from Svoy Doktor specialists

  Vomiting is a common clinical sign in small animal veterinary practice. It requires a rational approach to treatment based primarily on suspected or established pathology. A complete and detailed history is required to examine an animal with vomiting. It is most important to distinguish vomiting from regurgitation, since their etiology, on which specific diagnostic tests depend, is different. Regurgitation is a passive process in which undigested food or saliva is ejected spontaneously under the influence of gravity, while vomiting is a reflex accompanied by signs of nausea, increased salivation and contractions of the abdominal muscles.

  Maropitant. Trade name Serenia/ Cerenia

  This drug acts as an antiemetic by blocking the neurokinin-1 (NK1) receptor. Neurokinin-1 is a neurotransmitter that initiates vomiting from the vomiting center. Although NK1 receptors are involved in other physiological and behavioral responses, no side effects associated with blockade of other receptors have been reported at doses used to control vomiting. Maropitant can inhibit vomiting that is stimulated by both central and peripheral sources mediated by acetylcholine, histamine, dopamine, and serotonin. The NK1 receptor is also involved in pain transmission (via substance P). Blockade of the NK1 receptor may have potential as an adjunctive treatment for some types of pain (eg, visceral pain), but there are currently no clinical studies demonstrating an analgesic effect from maropitant. [1], [2], [3], [7]

  The drug effectively suppresses vomiting from chemotherapy, gastrointestinal diseases, intoxication, kidney disease, vestibular irritants (sickness). [4]

  Adverse reactions: pain reaction during injection. Very high doses in cats can cause hemolysis. The injections should not be mixed with any other agent as there are no compatibility studies.

  Maropitant is available as 16, 24, 60, or 160 mg tablets and 10 mg/mL injection. However, in the Russian Federation the tablet form is not available.

  Dosage: dogs, cats: 1 mg/kg daily or 2 mg/kg orally every 24 hours. To prevent motion sickness in foreign literature, tablets are used at a dose of 8 mg / kg per day for a maximum of 2 days.

  Metoclopramide. Trade name Cerucal/Reglan/Maxolon

  Antiemetic and prokinetic drug. Metoclopramide stimulates upper gastrointestinal motility and is a centrally acting antiemetic. Among the proposed mechanisms are stimulation of 5-HT (serotonin) receptors or increased release of acetylcholine in the gastrointestinal tract. Affinity for 5-HT4 receptors is low compared to other more effective motility-modifying drugs. It inhibits dopamine-induced relaxation of the stomach, thus enhancing the cholinergic responses of gastric smooth muscle to increase motility. It also increases the tone of the lower esophageal sphincter. Metoclopramide acts centrally by inhibiting dopamine, which is responsible for the antiemetic effects. The antiemetic effect is achieved through its antidopamine (D2) action.

  The main effect in dogs is its antiemetic properties. Because this drug transiently increases prolactin secretion, there has been interest in its use for the treatment of agalactia in animals, but its efficacy has not been determined. [5]

  Adverse effects are associated with blockade of central dopaminergic receptors. Use in patients with epilepsy or diseases caused by obstruction of the gastrointestinal tract is unacceptable. [6]

  Most commonly used for general antiemetic purposes, but doses up to 2 mg/kg have been used to prevent vomiting during cancer chemotherapy (higher doses may cause antiserotonin effects). [3]

  Metoclopramide is available as 5 and 10 mg tablets, 1 mg/ml oral solution and 5 mg/ml injection in 2, 10 and 30 ml vials.

  Dosage: 0.2-0.5 mg/kg every 6-8 hours IV, IM or orally. For antiemetic treatment in cancer chemotherapy, the dose used is up to 2 mg/kg per day.

  Ondansetron. Trade name Latran/Emetron/Zofran/ Zofran

  Ondansetron is an antiemetic drug in a class of drugs called serotonin antagonists. Like other drugs in this class, ondansetron works by inhibiting serotonin type 3 (5-HT3) receptors.

  In cats, oral absorption is 32% from oral administration and 75% from subcutaneous administration. In dogs, it is much less bioavailable (less than 10%) after oral administration and has a shorter half-life of 30 minutes, raising questions about the clinical efficacy of ondansetron in dogs.

  Only limited information is available on the efficacy of ondansetron in animals, but ondansetron has been found to be effective for treating chemotherapy vomiting in animals. [3], [5]

  No adverse effects of ondansetron have been reported in animals. Important contraindications in animals have not been identified. Dose modification is not required in animals with renal insufficiency.

  Ondansetron is available as 4 and 8 mg tablets and 2 mg/mL injections. Dosage for dogs and cats: 0.5-1 mg/kg 30 minutes before administration of chemotherapy drugs. Other causes of vomiting: 0.2-0.3 mg/kg, slow intravenous injection and repeated every 6-12 hours. If there is no effect, increase to 0.