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Anti-nausea: Zofran / Ondansetron

Zofran (generic name ondansetron, other brand names Emeset, Oncoden, Zofron) is a drug used to fight nausea (wanting to vomit - the medical term for a drug to prevent nausea is antiemetic). It was approved by the US FDA for chemotherapy induced nausea in January 1991. It has since been used for radiation therapy induced nausea, postoperative nausea and pregnancy nausea (category B drug). This page focuses on the chemotherapy / radiotherapy induced anti-nausea properties of this drug.

What does this drug do? Zofran is a selective blocking agent of the serotonin 5-HT3 receptor. In plain speak serotonin is released by the small intestine when given chemotherapy (and possibly in reaction to other events). This triggers the vomiting reflex. If this mechanism can be blocked with drugs such as Zofran, vomiting can be reduced or eliminated.

Other tidbits: this drug has been hailed by many cancer patients as a miracle in keeping nausea in check. This comes at a price - the drug may be expensive. Insurance often covers the cost and the manufacturer has a program for those who have financial hardship.

Forms of this drug: this drug comes in injectable (by vein) and two oral (by mouth) forms. The injectable form is often given in conjunction with chemotherapy. The oral form is suited for doctor prescribed patient use after chemotherapy or radiotherapy. A new form was approved February 1999 - Zofran ODT (orally disintegrating tablets) - strawberry flavored tablets that dissolve on the patient's tongue, not requiring water, which makes taking the medicine easier since the patient does not have to swallow a pill.

Dosing: Please refer to your doctor on dosing for this drug given your condition. It is often labeled that if you miss a dose take the dose unless it is almost time for the next dose - in that case skip the missed dose (do not double dose). The medicine should not be given to others.

Side Effects: Zofran may cause headache, constipation, stomach pain, weakness, or dry mouth although the incidence of side effects appears to be uncommon. It appears not to cause cancer in animals. Studies have shown it to not cause pregnancy problems in animals, hence it's pregnancy class B rating - you will want to discuss with your doctor the use of this drug if you are pregnant or breastfeeding (the drug is expressed in animal breast milk, humans have not been studied).

Precautions: Some people have shown sensitivity to this drug - if adverse effects are noted consult your doctor - hypersensitivity reactions have been noted in those who have hypersensitivity to other 5-HT3 drugs (Kytril / Granisetron is such a drug).

 

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Resources

Zofran main website http://www.zofran.com/

Information for chemotherapy nausea
Information for radiotherapy nausea
Patient Assistance Program

Monograph from RxList (long, more technical)
Information on serotonin drugs (technical)


Manufacturer


GlaxoSmithKline Inc. (US)
In the UK: 020 8047 5000
In the US: 888 825 5249
GlaxoSmithKline UK
GlaxoSmithKline contact information for different countries

 

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Since the early 1970s, incidence rates for non-Hodgkin’s lymphoma have nearly doubled. Incidence rates for Hodgkin’s disease have declined about 60%. Better means of diagnosis has also increased the number as doctors better understand cancer of lymphocytes verses other diseases.
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