MedPath

Ondansetron

Generic Name
Ondansetron
Brand Names
Zofran, Zuplenz
Drug Type
Small Molecule
Chemical Formula
C18H19N3O
CAS Number
99614-02-5
Unique Ingredient Identifier
4AF302ESOS

Overview

A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and has reported anxiolytic and neuroleptic properties. Having been developed in the 1980s by GlaxoSmithKline and approved by the US FDA since January 1991, ondansetron has demonstrated a long history of use and efficacy. Commonly formulated as oral tablets, orally disintegrating tablets (ODT), and injections, and available as generic products as well, ondansetron continues to see contemporary innovations in its formulation and use, including the development of orally soluble films that are both discreet in administration and less of a burden in comparison to having patients attempt to swallow pills during emesis. The FDA withdrew its approval for the use of all intravenous drug products containing more than 16 mg of ondansetron hydrochloride in a single dose, due to a high risk of QT prolongation.

Background

A competitive serotonin type 3 receptor antagonist. It is effective in the treatment of nausea and vomiting caused by cytotoxic chemotherapy drugs, including cisplatin, and has reported anxiolytic and neuroleptic properties. Having been developed in the 1980s by GlaxoSmithKline and approved by the US FDA since January 1991, ondansetron has demonstrated a long history of use and efficacy. Commonly formulated as oral tablets, orally disintegrating tablets (ODT), and injections, and available as generic products as well, ondansetron continues to see contemporary innovations in its formulation and use, including the development of orally soluble films that are both discreet in administration and less of a burden in comparison to having patients attempt to swallow pills during emesis. The FDA withdrew its approval for the use of all intravenous drug products containing more than 16 mg of ondansetron hydrochloride in a single dose, due to a high risk of QT prolongation.

Indication

In the adult patient population: i) orally administered ondansetron tablets and orally disintegrating tablets (ODT) are indicated for: - the prevention of nausea and vomiting associated with emetogenic cancer chemotherapy, including high dose (ie. greater than or equal to 50 mg/m2) cisplatin therapy, and radiotherapy, and - the prevention and treatment of postoperative nausea and vomiting ii) intravenously administered ondansetron injection formulations are indicated for: - the prevention of nausea and vomiting associated with emetogenic cancer chemotherapy, including high dose (ie. greater than or equal to 50 mg/m2) cisplatin therapy, and - the prevention and treatment of postoperative nausea and vomiting In the pediatric (4-18 years of age) patient population: i) ondansetron was effective and well tolerated when given to children 4-12 years of age for the treatment of post-chemotherapy induced nausea and vomiting, ii) ondansetron tablets, ondansetron ODT, ondansetron injection are not indicated for the treatment of children 3 years of age or younger, iii) ondansetron tablets, ondansetron ODT, ondansetron injection are not indicated for use in any age group of the pediatric population for the treatment of post-radiotherapy induced nausea and vomiting, and iV) ondansetron tablets, ondansetron ODT, ondansetron injection are not indicated for use in any age group of the pediatric population for the treatment of postoperative nausea and vomiting In the geriatric (>65 years of age) patient population: i) efficacy and tolerance of ondansetron were similar to that observed in younger adults for the treatment of post-chemotherapy and radiotherapy-induced nausea and vomiting, and ii) clinical experience in the use of ondansetron in the prevention and treatment of postoperative nausea and vomiting is limited and is not indicated for use in the geriatric patient population

Associated Conditions

  • Chemotherapy-Induced Nausea and Vomiting
  • Cholestatic pruritus
  • Post Operative Nausea and Vomiting (PONV)
  • Radiation-Induced Nausea and Vomiting
  • Uremic Pruritus
  • Severe Hyperemesis gravidarum

FDA Approved Products

ONDANSETRON
Manufacturer:Fresenius Kabi USA, LLC
Route:INTRAVENOUS, INTRAMUSCULAR
Strength:4 mg in 2 mL
Approved: 2023/01/05
NDC:76045-216
ONDANSETRON
Manufacturer:Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.
Route:INTRAVENOUS, INTRAMUSCULAR
Strength:2 mg in 1 mL
Approved: 2021/06/08
NDC:23155-548
ONDANSETRON
Manufacturer:Rnabaxy Pharmaceuticals Inc.
Route:ORAL
Strength:8 mg in 1 1
Approved: 2014/01/06
NDC:63304-347
ONDANSETRON
Manufacturer:Rnabaxy Pharmaceuticals Inc.
Route:ORAL
Strength:4 mg in 1 1
Approved: 2014/01/06
NDC:63304-346
Ondansetron
Manufacturer:Advanced Rx Pharmacy of Tennessee, LLC
Route:ORAL
Strength:4 mg in 1 1
Approved: 2024/02/22
NDC:80425-0228

Singapore Approved Products

ONDANSETRON-AFT SOLUTION FOR INJECTION 2MG/ML
Manufacturer:Qilu Pharmaceutical Co., Ltd
Form:INJECTION, SOLUTION
Strength:2mg/ml
Online:Yes
Approved: 2016/05/18
Approval:SIN15006P
ODNATRON Film Coated tablet 8 mg
Manufacturer:KLEVA S.A.
Form:TABLET, FILM COATED
Strength:8mg
Online:Yes
Approved: 2009/10/27
Approval:SIN13714P
NATZO 8 TABLETS 8 mg
Manufacturer:Natco Pharma Limited - Pharma Division
Form:TABLET
Strength:8.0 mg
Online:Yes
Approved: 2018/02/09
Approval:SIN15424P
Ondansetron Sandoz 8mg Tablets
Manufacturer:Novartis (Bangladesh) Limited
Form:TABLET, FILM COATED
Strength:8mg
Online:Yes
Approved: 2008/04/16
Approval:SIN13446P
ONDANSETRON FRESENIUS INJECTION 2MG/ML
Manufacturer:PT. Ethica Industri Farmasi (PT. Ethica)
Form:INJECTION, SOLUTION
Strength:2MG/ML
Online:Yes
Approved: 2020/09/25
Approval:SIN16020P

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