Ondansetron

Table of contents

  • Brand Names
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Unlabeled Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Caution and personalized dose adjustment in patients with the following genotypes
  • Other genes that may be involved
  • Substrate of
  • Inhibits
  • Drug Interactions
  • Nutrition/Nutraceutical Interactions
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Austria: Ondansetron, Zofran; Belgium: Avessaron, Ondansetron, Zofran; Bulgaria: Emetron, Setronon, Zofran, Zondaron; Cyprus: Zofran; Czech Republic: Danemet, Emeset, Novetron, Ondansetron, Ondemet, Setronon, Zofran; Denmark: Ondansetron, Zofran, Zotrix; Estonia: Emetron, Ondansetron, Zofran; Finland: Ondansetron, Zofran; France: Aodrin, Ondansetron, Orfibu, Zamanol, Zophren; Germany: Axisetron, Cellondan, Ondahexal, Ondansetron, Ondatron, Sigondan, Zofran, Zofron; Greece: Ondansetron, Ondeton, Zetron, Zofron; Hungary: Antivom-Teva, Emetron, Ondagen, Ondansetron, Zofran; Ireland: Emital, Emizof, Ondansetron, Ondran, Zofran; Italy: Belofran, Ondansetron, Ondansetrone, Zofran; Luxembourg: Emetron, Ondansetron, Setronon, Zofran; Netherlands: Ondansetron, Zofran; Poland: Atossa, Ebesetron, Emeset, Emetron, Ondagen, Ondahexal, Ondalek, Ondansetron, Setronon, Zofran; Portugal: Emetron, Nausiend, Ondansetrom, Otobrol, Zofran; Romania: Emeset, Ondansetron, Ondaran, Osetron, Setronon, Zofran; Slovakia: Ondansetron, Ondemet, Onsetrogen, Zofran; Slovenia: Ondansetron, Onilat, Setronon, Zofran; Spain: Ondansetrón, Yatrox, Zofrán; Sweden: Ondansetron, Zofran, Zotrix; UK: Ondansetron, Ondemet, Zofran.

North America

Canada: Ondansetron, Zofran; USA: Ondansetron, Zofran, Zuplenz.

Latin America

Argentina: Cetrón, Dantenk, Dismolán, Espasevit, Finaber, Ondansetrón, Tiosalis, Zofrán; Brazil: Ansentron, Ondansetrona, Modifical, Nausedron, Ontrax, Vonau, Zofran; Mexico: Danac, Dosatrón, Modifical, Nalisen, Nodantón, Onancén, Ondal, Ondansetrón, Precirux, Vosrym, Zofrán.

Asia

Japan: Ondansetron, Zofran.

Drug combinations

Chemistry

Ondansetron Hydrochloride: C~18~H~19~N~3~O HCl 2H~2~O. Mw: 365.85. (1) 4H-Carbazol-4-one, 1,2,3,9-tetrahydro-9-methyl-3-[(2-methyl-1H-imidazol-1-yl)methyl]-, monohydrochloride, (±), dihydrate; (2)(±)-2,3-Dihydro-9-methyl-3-[(2-methylimidazol-1-yl)methyl]carbazol-4(1H)-one monohydrochloride dihydrate. CAS-103639-04-9 (1989).

Pharmacologic Category

Antiemetics; 5-HT~3~ Receptor Antagonists. (ATC-Code: A04AA01).

Mechanism of action

Has antiemetic activity by its selective 5-HT~3~ receptor antagonism, blocking serotonin, both centrally (in medullary chemoreceptor trigger zone) and peripherally (in gastrointestinal tract).

Therapeutic use

Prevention of nausea and vomiting associated with moderately- to highly-emetogenic cancer chemotherapy. Radiotherapy in patients receiving total body irradiation or fractions to abdomen. Prevention and treatment of postoperative nausea and vomiting.

Pregnancy and lactiation implications

Teratogenic effects not observed in animals. There are no adequate studies in pregnant women. Use generally reserved for severe hyperemesis gravidarum or when conventional treatments not effective. Excretion in breast milk unknown (use caution).

Unlabeled use

Early-onset alcoholism. Hyperemesis gravidarum.

Contraindications

Hypersensitivity to ondansetron, other selective 5-HT~3~ antagonists, or any component of the formulation.

Warnings and precautions

Use with caution in allergy to other 5-HT~3~ receptor antagonists (cross-reactivity reported). Selective 5-HT~3~ antagonists, including ondansetron, associated with a number of dose-dependent increases in ECG intervals, usually occurring 1-2 hours after I.V. administration. Reduction in heart rate may also occur with 5-HT~3~ antagonists. I.V. formulations of 5-HT~3~ antagonists have more association with ECG interval changes, compared to oral formulations. Use with caution in congenital long QT syndrome or other risk factors for QT prolongation (medications known to prolong QT interval, hypokalemia or hypomagnesemia, and cumulative high-dose anthracycline therapy). Orally-disintegrating tablets contain phenylalanine. For chemotherapy, should be used on a scheduled basis, and only in first 24-48 hours. Data does not support any increased efficacy in delayed nausea and vomiting. Does not stimulate gastric or intestinal peristalsis (may mask progressive ileus and/or gastric distension).

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