Zofran
® (
ondansetron hydrochloride) is a prescription medicine that has been licensed to prevent nausea and vomiting due to several causes.
Zofran is manufactured by GlaxoSmithKline.
Uses of Zofran include preventing the following:
- Nausea and vomiting associated with chemotherapy
- Nausea and vomiting due to radiation therapy for cancer
- Postoperative nausea and vomiting that can occur after surgery.
The medication is not intended to treat nausea or vomiting that is already occurring.
Nausea (upset stomach) and vomiting are complex processes involving many chemicals in the body and several parts of the body, including the brain and the small intestine. It is likely that Zofran works in the small intestine, but it may also work in the brain. The medication blocks serotonin, a chemical produced by the body that is associated with nausea and vomiting. Serotonin has many effects in the body and has several receptors where it can bind. Zofran blocks serotonin at a specific type of receptor (the 5-HT3 receptor).
Several studies have looked at how well Zofran prevents nausea and vomiting due to several causes.
High-Risk Chemotherapy
One study looked at Zofran for chemotherapy regimens that were likely to cause nausea and vomiting. Of the people that took the drug, 66 percent had no vomiting and 56 percent had no nausea within the first day after chemotherapy. Vomiting was much more likely for people who did not take Zofran; more than 90 percent of these people experienced vomiting. This study did not look at nausea or vomiting beyond the first day after chemotherapy.
Medium-Risk Chemotherapy
Zofran was also studied for chemotherapy regimens that had a medium risk for nausea and vomiting. This study looked at the likelihood of vomiting during the three days after chemotherapy. For the people who took Zofran, 61 percent had no vomiting, compared to only 6 percent with no vomiting for those who did not take it. Another study showed that the drug continued to be effective for additional cycles of chemotherapy.
Chemotherapy and Children
Several studies have looked at using Zofran to prevent vomiting in children (ages 4 to 18) receiving chemotherapy. These studies showed that the medication was just as effective in children as it was in adults.
Radiation
Several studies have looked at how well Zofran prevents nausea and vomiting for people undergoing radiation treatments. In studies of people having total body irradiation and daily fractionated radiation, people who took this drug were less likely to have vomiting than people who did not take it. In a study of people having single high-dose fraction radiation, Zofran worked better than another medication,
metoclopramide (
Reglan®), at preventing vomiting.
Surgery
Zofran for the prevention of vomiting and/or nausea after surgery (postoperative nausea and vomiting) has been examined in two studies. In these studies, people who took the drug one hour before anesthesia were less likely to have nausea and vomiting compared to people who did not take it. These studies involved women only, mainly because women are more likely to have nausea and vomiting after surgery.
Nausea
Vomiting is usually much easier to prevent than nausea. Many of the studies of Zofran either did not look at nausea or did not show that it was effective for nausea.
When and How to Take Zofran
Some general considerations for when and how to take Zofran include the following:
- The medication comes in several forms: tablets, orally disintegrating tablets (they dissolve in the mouth), and solution (a strawberry-flavored liquid). All of these forms are taken orally. Zofran also comes in an intravenous (IV) form your healthcare provider gives to you.
- Zofran should be taken 30 minutes before the start of chemotherapy. Your healthcare provider may instruct you to take further doses after the first one.
- The medication should be taken one to two hours before radiation. The dose after radiation depends on the type of radiation.
- Zofran should be taken one hour before surgery begins.
- Zofran can be taken with or without food.
- The orally disintegrating tablets will quickly dissolve in your mouth, with no need for water. You should keep each tablet in its original blister pack until you need it. Do not try to push the tablet through the foil (the tablet is delicate and would be crushed). Instead, gently peel the foil away and remove the tablet.
- For Zofran to work properly, it must be taken as prescribed. The medication will not work if you stop taking it.
The dose of Zofran your healthcare provider recommends will vary, depending on a number of factors, including:
- Your age
- The medical condition you are being treated for
- Other medical conditions you may have
- Other medications you may be taking.
As with any medication, do not adjust your dose unless your healthcare provider specifically instructs you to do so.
As with any medicine, side effects are possible with Zofran. However, not everyone who takes it will experience side effects. In fact, most people tolerate the medication well. If side effects do occur, they are often minor and either require no treatment or can easily be treated by you or your healthcare provider. Serious side effects are less common.
The most common side effects include:
(Click Zofran Side Effects to learn more, including potentially serious side effects you should report to your healthcare provider.)
You can also read about specific side effects in the following eMedTV articles:
What Should I Tell My Healthcare Provider?
You should talk with your healthcare provider before taking this drug if you have:
- Liver problems, including cirrhosis
- An arrhythmia (an irregular heart rhythm), especially long QT syndrome
- Phenylketonuria
- Any allergies, including allergies to foods, dyes, or preservatives.
Also, let your healthcare provider know if you:
- Have severe or constant nausea or vomiting that is not helped by Zofran. Also, talk with your healthcare provider if you are vomiting blood.
- Have severe vomiting and diarrhea. This combination of problems can lead to dehydration and electrolyte imbalances.
Tell your healthcare provider about all the medicines you are currently taking, including prescription and non-prescription medicines, vitamins, and herbal supplements.
What If I Take an Overdose?
People who take too much Zofran may have overdose symptoms that could include:
If you happen to take too much, seek immediate medical attention.
How Should Zofran Be Stored?
Zofran should be stored at room temperature away from moisture or heat. The tablets should be kept in an airtight container. The orally disintegrating tablets should be kept in their original blister packs until ready to use.
Keep this and all medications out of the reach of children.
What Should I Do If I Miss a Dose?
If you do not take your Zofran as scheduled, take your missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and continue with your regular schedule. Do not take a double dose.
Zofran comes in several strengths and forms:
- Zofran 4 mg tablets
- Zofran 8 mg tablets
- Zofran ODT 4 mg orally disintegrating tablets
- Zofran ODT 8 mg orally disintegrating tablets
- Zofran oral solution 5 mg per 5 mL (one teaspoon)
- Zofran injection.
At this time, Zofran is not available in generic form
(see Zofran Generic for more information).
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