+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Ondansetron--the first of a new class of antiemetic agents



Ondansetron--the first of a new class of antiemetic agents



Clinical Pharmacy 10(6): 430-446



The chemistry, pharmacokinetics, adverse effects, stability, compatibility, and dosage of ondansetron hydrochloride are described, and clinical studies of the use of ondansetron for the prophylaxis of nausea and vomiting induced by antineoplastic therapy are reviewed. Ondansetron hydrochloride is a specific antagonist of serotonin type 3 (5-HT3) receptors, both in the chemoreceptor trigger zone and in the GI tract. Peak plasma concentrations of ondansetron occur approximately one hour after an oral dose and 6 to 20 minutes after an i.v. dose. The mean elimination half-life is approximately 3.5 hours in healthy volunteers, but it is extended in elderly patients (mean of 7.9 hours). In clinical trials, ondansetron has been shown to provide excellent control of nausea and vomiting in patients treated with cisplatin. Comparisons of ondansetron with metoclopramide in patients treated with various types of chemotherapy have shown better response rates with ondansetron. Ondansetron has also been shown to be effective in controlling nausea and vomiting in patients receiving cyclophosphamide with an anthracycline and in patients receiving combination therapy with cyclophosphamide, methotrexate, and fluorouracil. Adverse effects appear to be mild and include headache, constipation, diarrhea and transient abnormalities in liver function tests. The dose of ondansetron (as the hydrochloride salt) for the prophylaxis of chemotherapy-induced nausea and vomiting in adults is 0.15 mg/kg i.v. every four hours for three doses, beginning 30 minutes before antineoplastic therapy. The efficacy of ondansetron is comparable to that of metoclopramide, and the adverse-effect profile is much less problematic. The cost of ondansetron is much higher than that of metoclopramide; thus its use should be limited to patients at high risk for metoclopramide-induced adverse effects and patients in whom metoclopramide is ineffective.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 040864778

Download citation: RISBibTeXText

PMID: 1829668


Related references

Severe Proarrhythmic Potential of the Antiemetic Agents Ondansetron and Domperidone. Cardiovascular Toxicology 17(4): 451-457, 2017

Antiemetic therapy with the 5 ht 3 antagonist ondansetron in cisplatin induced vomiting refractory to standard antiemetic regimens. Journal of Cancer Research & Clinical Oncology 116(SUPPL PART 1): 523, 1990

Comparison of ondansetron and ondansetron plus dexamethasone as antiemetic prophylaxis during cisplatin-containing chemotherapy. Lancet 338(8765): 487-490, 1991

Comparison of ondansetron with ondansetron plus dexamethasone for antiemetic prophylaxis in children undergoing strabismus surgery. Journal of Pediatric Ophthalmology and Strabismus 41(2): 100-104, 2004

Enhancement of the antiemetic action of ondansetron by transcutaneous electrical stimulation of the p6 antiemetic point in patients having highly emetic cytotoxic drugs. British Journal of Cancer 64(5): 971-972, 1991

Does ondansetron plus dexamethasone enhance the antiemetic efficacy of ondansetron?. Anesthesia & Analgesia 78(2 SUPPL ): ABSTRACT S280, 1994

Randomized, double-blind comparison of ondansetron versus ondansetron plus metopimazine as antiemetic prophylaxis during platinum-based chemotherapy in patients with cancer. Journal of Clinical Oncology 15(4): 1690-1696, 1997

Use of oral ondansetron versus intravenous ondansetron as initial antiemetic therapy in oncology patients receiving moderate to highly emetogenic regimens. Pharmacotherapy 22(10): 1379, 2002

A randomized trial to compare the efficacy and safety of antiemetic treatment with ondansetron and ondansetron zydis in patients with breast cancer treated with high-dose epirubicin. Anticancer Research 27(6c): 4411-4417, 2008

The efficacy of a combination of ondansetron, methylprednisolone and metopimazine in patients previously uncontrolled with a dual antiemetic treatment in cisplatin-based chemotherapy. The French Ondansetron Study Group. Annals of Oncology 8(9): 887-892, 1997

A new class of antiemetic agents on the horizon. Clinical Journal of Oncology Nursing 6(2): 103-104, 2002

Prophylactic antiemetic therapy with patient-controlled analgesin: Comparison of metoclopramide, droperidol, ondansetron and a combination of ondansetron and droperidol. Wuhan Daxue Xuebao (Yixue Ban) 25(5): 571-573, 2004

Comparison of the Efficacy of Dexamethasone, Ondansetron, and Ondansetron Plus Dexamethasone as Antiemetic and Antipruritic Therapy in Patients Receiving Intrathecal Morphine. Anesthesiology Abstracts of Scientific Papers Annual Meeting ( ): Abstract No A-73, 2002

Ondansetron plus metopimazine compared with ondansetron plus metopimazine plus prednisolone as antiemetic prophylaxis in patients receiving multiple cycles of moderately emetogenic chemotherapy. Journal of Clinical Oncology 19(7): 2091-2097, 2001

Antiemetic prophylaxis against postoperative nausea and vomiting with ondansetron-dexamethasone combination compared to ondansetron or dexamethasone alone for patients undergoing laparoscopic cholecystectomy. Kathmandu University Medical Journal 6(23): 319-328, 2010