Ondansetron

May be taken with or without food.

Hypersensitivity. Congenital long QT syndrome. Concomitant use with apomorphine.

Patient with hypokalaemia, hypomagnesaemia, CHF, CV conduction abnormalities, bradyarrhythmia, other conditions that may develop prolongation of QT interval or electrolyte abnormalities, phenylketonuria, subacute intestinal obstruction and abdominal surgery. May mask progressive ileus or gastric distension and occult bleeding in adenotonsillar surgery. Moderate to severe hepatic impairment. Elderly and children. Pregnancy and lactation. Monitoring Parameters Monitor ECG, serum K, and serum Mg. Monitor for signs and symptoms of serotonin syndrome and decreased bowel activity.

Significant: Chest pain, bradycardia, hypotension, arrhythmia, hypoxia, transient elevation of liver enzymes, transient blurred vision (due to rapid IV inj). Rarely, transient blindness, extrapyramidal symptoms (e.g. dystonic reactions, oculogyric crisis, dyskinesia), seizures, toxic epidermal necrolysis, serotonin syndrome. Gastrointestinal disorders: Constipation, diarrhoea, hiccup, xerostomia, dyspepsia. General disorders and administration site conditions: Malaise, fatigue, fever, cold sensation, injection site reaction, local burning sensation following supp insertion. Investigations: ECG changes. Nervous system disorders: Headache, dizziness, sedation, drowsiness, paraesthesia. Psychiatric disorders: Insomnia, anxiety. Renal and urinary disorders: Urinary retention. Reproductive system and breast disorders: Gynaecological disease. Skin and subcutaneous tissue disorders: Rash, pruritus. Vascular disorders: Flushing, syncope.
Potentially Fatal: QT interval prolongation, torsade de pointes. Rarely, liver failure, anaphylaxis and bronchospasm.

Dexamethasone Na phosphate may potentiate antiemetic effect. May develop serotonin syndrome (including altered mental status, autonomic instability, neuromuscular abnormalities) with SSRIs, MAOIs, mirtazapine, fentanyl, lithium, methylene blue, serotonin noradrenaline reuptake inhibitors (SNRIs). Potent CYP3A4 inducers (e.g. phenytoin, carbamazepine, rifampicin) may reduce plasma concentrations and increase clearance of ondansetron. Coadministration with antiarrhythmics (e.g. amiodarone), atenolol, anthracyclines (e.g. doxorubicin, daunorubicin), trastuzumab, erythromycin, and ketoconazole may cause additive prolongation of QT interval and increase risk of arrhythmia. May decrease analgesic effect of tramadol.

Antiemetics / Supportive Care Therapy

A04AA01 - ondansetron ; Belongs to the class of serotonin (5HT3) antagonists. Used for the prevention of nausea and vomiting.