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ondansetron (ondansetron, ODT / Zofran ODT)

✓ Approved

GSK · HTR3A · Small Molecule

What is ondansetron?

ondansetron is a small molecule developed by GSK. It is approved for therapeutic indications via oral (po).

Drug Profile

Brand Namesondansetron, ODT, Zofran ODT
CompanyGSK
Drug ClassSmall Molecule
Molecular TargetHTR3A
RouteOral (PO)
StatusApproved
Sources: ClinicalTrials.gov, GSK

Mechanism of Action

Molecular Targets

ondansetron acts on 1 molecular target:

HTR3A5-hydroxytryptamine receptor 3A (5-HT3R, 5-HT-3)
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Related Research Articles

PubMedInternational journal of pharmaceutical compounding2026-09-17

Stability Evaluation of Compounded Multidrug Oral Liquids in a Dual-Vehicle Suspending System.

Kegele Carolina Schettino CS, Taylor Sarah S, Polonini Hudson H

Extemporaneously compounded oral liquids are essential for patients unable to swallow solid dosage forms, although ensuring stability in aqueous systems remains challenging. This study evaluated the chemical, physical, and microbiological stability of formulations containing topiramate, omeprazole, gabapentin, ondansetron, and levofloxacin prepared in Flavor Sweet™ SF and Flavor Plus™, also known as Syra Sweet™ SF and Syra Plus™. Stability was assessed over 90 days at room temperature and under refrigeration using validated UHPLC methods, along with physical and microbiological analyses. Gabapentin, ondansetron, omeprazole, and topiramate remained stable for 90 days under both conditions, while levofloxacin was stable for 60 days at room temperature and 90 days refrigerated. All formulations showed consistent pH and acceptable microbiological quality, although precipitation in some samples led to discontinuation of analysis. These results support the suitability of the vehicle system and highlight the importance of formulation parameters in stability and beyond-use dating.

PMID 42752430
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PubMedJournal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC2026-09-17

SOGC Clinical Practice Guideline No. 471: Alcohol and Pregnancy.

Allen Victoria V, Cook Jocelynn L JL, Chandrasekaran Nirmala N, Christie Janet J et al.

To establish national standards of care for screening and counselling pregnant women and individuals of reproductive age regarding alcohol consumption and alcohol use disorder. Health care providers who care for pregnant women and women of childbearing age. Pregnant women and women of childbearing age and their families. Medline, EMBASE, and CENTRAL databases were searched for "alcohol use and pregnancy". The results were filtered for a publication date between October 2018 and February 2026. The search terms were developed using the MeSH terms and key words including: pre-pregnancy, pregnant, breast feeding, lactation, female, women, preconception care, prenatal care, Fetal Alcohol Spectrum Disorder, prenatal alcohol exposure, drinking behavior, alcohol abstinence, alcohol drinking, binge drinking, Alcohol-Related Disorders, alcoholism, alcohol consumption, alcohol abuse, benzodiazepines, disulfiram, naltrexone, acamprosate, ondansetron, topiramate, cyanamide, calcium carbimide, alcohol deterrents, disease management, detoxification, Alcoholics Anonymous, alcohol counselling, harm reduction, pre-pregnancy care, prenatal care, incidence, prevalence, epidemiological monitoring, brief intervention. Clinical trials, observational studies, reviews, systematic reviews and meta-analysis, guidelines, and conference consensus were included. The table of evidence from the search that supports the recommendations is included as Appendix B. The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional recommendations). Implementation of the recommendations in these guidelines may increase obstetrical care provider recognition of alcohol consumption and problematic alcohol use among women of childbearing age or who are pregnant using validated screening tools and brief intervention approaches. Obstetrician-gynecologists should be given priority access to healthcare professionals with expertise in alcohol cessation for their patients in order to support optimal health and pregnancy outcomes. As they are already responsible for the urgent management of pregnancy-related complications, they must be able to rely on expedited referral pathways to ensure timely interventions. RECOMMENDATIONS: (Recommendations IN BOLD are new to this guideline update; an overview of the updated supporting literature for all recommendations is provided in Appendix B).

PMID 42753357
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PubMedEuropean heart journal. Cardiovascular pharmacotherapy2026-09-16

Antiemetic-Associated QT Prolongation: A Clinical Review and Risk-Stratified Prescribing Framework for Long QT Syndrome.

Moustafa Ahmed T AT, Dabash Omar O, Panigrahi Pradosh Kumar PK, Khan Habib Rehman HR

Nausea and vomiting accompany pregnancy, gastroenteritis, migraine, the perioperative period, and cytotoxic chemotherapy, and antiemetics are among the most frequently prescribed drugs worldwide. Several antiemetic classes delay ventricular repolarization and prolong the QT interval, a substrate for torsades de pointes (TdP), ventricular fibrillation, and sudden cardiac death. We synthesized the evidence on antiemetic QT liability and translated it into a three-tier, risk-stratified prescribing framework and stepwise clinical algorithm for patients with inherited or acquired long QT syndrome (LQTS) and other torsadogenic risk factors. We conducted a narrative review of PubMed/MEDLINE, EMBASE, and pharmacovigilance sources (FDA Adverse Event Reporting System, CredibleMeds/QTdrugs) through early 2026, prioritizing mechanistic studies, randomized comparisons, disproportionality analyses, and consensus statements on antiemetic QT liability and LQTS management. QT prolongation across antiemetic classes is driven principally by IKr blockade (hERG/KCNH2). Risk is highly heterogeneous within classes: in a 2026 FAERS disproportionality analysis, ondansetron carried a substantially stronger QT-related signal than olanzapine (reporting odds ratio 27.2 vs 8.7), consistent with its dose-dependent effect among 5-HT3 antagonists, which prompted a 2012 FDA restriction on the 32 mg intravenous dose; palonosetron has minimal effect. Neurokinin-1 antagonists, low-risk antihistamines, anticholinergics, and 5-HT4 agonists carry little QT liability, while butyrophenones, phenothiazines, and promethazine carry greater risk. Serious events cluster in patients with electrolyte disturbance, bradycardia, polypharmacy, or underlying LQTS, particularly when QTc exceeds 500 ms or rises more than 60 ms from baseline. Antiemetic-associated arrhythmia is largely preventable. Structured risk assessment, electrolyte correction, ECG monitoring, and a stepwise selection strategy favouring agents with minimal QT liability allow clinicians to manage nausea and vomiting safely, even in high-risk populations.

PMID 42748473
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PubMedThe journal of international advanced otology2026-09-13

Lateral Semicircular Canal Occlusion in Patients with Refractory Meniere's Disease.

Zernotti Mario Emilio ME, Andrian Lola Gonzalez LG, Binetti Ana Carolina AC, Pacheco Victor V et al.

Meniere's disease remains a controversial condition not only in terms of its etiology and diagnosis but also its treatment. Approximately 2%-5% of patients do not improve or reach the control of their vestibular symptoms with any pharmacological therapy. Surgery of lateral semicircular canal (LSCC) occlusion could be an alternative to control the symptoms. Twenty consecutive patients with clinical and oto-neurological diagnosis of Meniere's disease were included. Twelve women and 8 men with a mean age of 51 years (range, 29-72) were studied. All affected with unilateral or at least marked unilateral asymmetry in audio-gram. All patients who underwent surgery received general anesthesia. Canal wall up mastoidectomy was performed. After the LSCC was identified, a bony surface of the semicircular canal was drilled using a 1 mm diamond burr until the membranous labyrinth was discovered (blue line). The canal was then blocked with a mixture of bone wax and bone dust in an area of 2 or 3 mm, at the most prominent part of the semicircular canal. All patients in the study had an average hospital stay of 36 hours, of which 10 required additional medication (ondansetron). All were given 75 mg of cinnarizine orally once daily for 10 days. After that, only 4 patients continued taking betahistine for 1 month. One month later, no patients were taking medication for vertigo. Lateral semicircular canal occlusion seems to be an effective surgical option for patients with refractory Meniere's disease.

PMID 42732623
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PubMedAnnals of medicine and surgery (2012)2026-09-11

Addition of lidocaine to prophylactic ondansetron and dexamethasone in high-risk adults for postoperative nausea and vomiting: a randomized, controlled, double-blinded study.

Yi Ke-Xin KX, Du Ming-Cheng MC, Zheng Jia J, Long Xiang X et al.

A triple combination of dexamethasone, ondansetron, and droperidol is recommended as prophylaxis to prevent postoperative nausea and vomiting in high-risk patients. However, the administration of droperidol is controversial owing to its fatal side effects. Considering the antiemetic effect of lidocaine, the aim of this study was to determine if its incorporation could mitigate postoperative nausea and vomiting in adults at high risk. This randomized, controlled, double-blind study was conducted from 10 June 2023 to 31 October 2023. Based on a preliminary experiment, 260 patients were enrolled in the trial, with 130 in group C (saline) and 130 in group L (lidocaine). The primary outcome was the incidence of postoperative nausea and vomiting at 24 hours postoperatively. The secondary outcomes were the Quality of Recovery-40 (QoR-40) score at 24 hours postoperatively and the time to extubation. Adverse events that occurred during the study were recorded. The incidence of postoperative nausea and vomiting differed between the groups, with 26.6% (33 patients) in group C and 16.4% (21 patients) in group L (P = 0.0484). The QoR-40 score was 176.45 ± 10.87 in group C and 186.59 ± 9.79 in group L (P < 0.001). No adverse events were observed during the trial. In high-risk patients, the addition of lidocaine to ondansetron and dexamethasone effectively reduced the incidence of postoperative nausea and vomiting and improved the quality of recovery.

PMID 42725260
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PubMedAnesthesia and analgesia2026-09-10

A Double-Blinded Randomized Trial Comparing Dexamethasone to Ondansetron as the First-Line Antiemetic After Cesarean Delivery.

Berger Amnon A AA, Borrelli Maria C MC, Patrocinio Maria M, Armstrong Samantha L SL et al.

Postoperative nausea and vomiting is a common adverse outcome after cesarean delivery. Both ondansetron and dexamethasone are effective prophylactic medications; however, dexamethasone has also been shown to decrease pain medication use after cesarean delivery. We hypothesize that dexamethasone may be preferred as the first-line agent due to the dual benefit of reduced nausea and opioid consumption. Prospective randomized, double-blinded, controlled trial comparing dexamethasone 8 mg to ondansetron 4 mg. Patients received spinal anesthesia including morphine150 µg, and an enhanced recovery after cesarean protocol with scheduled nonopioid analgesic medications. The main outcome was the total number of medications for the treatment of any nausea and vomiting, pain, or pruritus in the first 24 hours following cesarean. One hundred patients were enrolled and 95 completed the trial. We found no difference in the mean (95% confidence interval of the mean) number of postoperative medications (ondansetron 0.23 [0.11-0.35], dexamethasone 0.40 [0.20-0.61] medications per patient per 24 hours; P = .337). Differences in the use of supplemental pain medications and pain scores were not statistically significant over the 24-hour period. Similarly, differences in nausea and pruritus scores were not statistically significant over 24 hours. We found no differences in the number of medications used to treat pain, nausea, or pruritus in the first 24 hours after cesarean delivery between women who received either ondansetron or dexamethasone. We also found no difference in pain despite prior research showing improvement with dexamethasone, which may be due to the low pain scores and rate of breakthrough postoperative pain in our study.

PMID 42721472
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