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PRODUCT SYNOPSIS
Ondansetron, sold under the brand name TravelSet® Oral Spray, is an anti-emetic drug, belonging to the first-generation serotonin (5-hydroxytryptamine or 5-HT) receptor antagonist class.
PHARMACOLOGICAL ACTION
Ondansetron exhibits anti-emetic action by antagonising vomiting signals in the afferent pathway from the stomach or small intestine and solitary tract nucleus (a crucial brainstem region responsible for processing sensory information related to taste, visceral sensations, and certain autonomic functions, located in the medulla oblongata).2
Additional Pharmacological Effect: Ondansetron, being a selective serotonin 5-HT3 receptor antagonist, is effective in treating certain types of pruritus involving serotonin-related mechanisms, including uremic pruritus (since serotonin plays a role as a mediator of itching).5
MECHANISM OF ACTION
- Ondansetron is a specific antagonist of serotonin type-3 receptors.
- To stop nausea and vomiting, Ondansetron works;
- centrally in the chemoreceptor trigger zone (postrema/NTS area) (near the medulla oblongata) and,
- peripherally at the vagal nerve terminals
- Ondansetron’s absence of antagonist activity on dopamine and other non-5-HT3 receptors indicates that, unlike other anti-emetics like metoclopramide, it doesn’t cause extrapyramidal or other dose-limiting side effects.3
BENEFITS
- Beneficial for patients with drug overdose, poisoning, anti-infective therapies, uraemia, neurological trauma, and pruritus.
- Improves gastrointestinal motility disorders like carcinoid syndrome, irritable bowel syndrome, cryptosporidiosis, diabetes-related diarrhea, and chronic refractory diarrhea.
- It helps patients with certain pain or CNS-related disorders like alcohol dependence, opiate withdrawal, vertigo, cerebellar tremor, and Parkinson’s disease treatment-related psychosis.
- It also aids in anti-infective/antidepressant therapies or pruritus in cholestatic jaundice. (not used as primary treatment).
- Effective in preventing PONV.
INDICATIONS
- Nausea and vomiting induced by cancer chemotherapy, or anaesthesia and surgery.
- Nausea/ vomiting associated with overdosage/poisoning of theophylline, paracetamol, colchicine or baclofen.
- Gastrointestinal motility disorders (e.g., carcinoid syndrome, irritable bowel syndrome, diarrhea linked to diabetes or cryptosporidiosis, and chronic refractory diarrhea)
- Vomitation sensation caused by specific pain or central nervous system disorders (e.g., alcohol (ethanol) dependence, opiate withdrawal, vertigo, cerebellar tremor, and psychosis related to Parkinson’s disease treatment).2
- Seasickness (Typically experienced during boat or ship travel)4
CONTRAINDICATIONS
Not usually advised for children with gastroenteritis whose primary symptom is moderate to severe diarrhea because ondansetron’s most frequent adverse effect is diarrhea.6
Not recommended for cardiac patients due to the risk of QT prolongation (cardiac electrophysiological disorder).
SIDE EEFFECTS/ ADVERSE REACTIONS
Diarrhea, headache, fever, drowsiness, constipation, rash, blurred vision, and muscle spasm. Ondansetron is linked to lower sedation incidence compared to conventional antiemetics.
DRUG INTERACTIONS
No prominent drug interactions reported.
RECOMMENDED DOSAGE
The recommended dose of oral Ondansetron for Postoperative nausea and vomiting (PONV) prophylaxis is 4 or 8 mg. Meta-analysis suggests 8 mg as the optimal dose.
IV ondansetron 4 mg is generally used due to the lower body mass in Indian patients compared to their Western counterparts.3
ADMINISTRATION
Oral sprays of Ondansetron are administered by spraying directly into the mouth, which targets local or systemic absorption.
CONCLUDING REMARKS
Ondansetron is U.S. FDA-approved for preventing postoperative, chemotherapy-induced, and radiotherapy-induced nausea and vomiting.
Due to its higher efficacy and relatively lower adverse effect profile as compared to conventional antiemetic agents, this 5-HT3 receptor antagonist has become one of the agents of choice for controlling emesis. 1
Travel Set Ondansetron Spray offers convenience in certain situations.
REFERENCES
- Israili, Z. H. (2001). Clinical pharmacology of serotonin receptor type 3 (5-HT3) antagonists. Current Medicinal Chemistry – Central Nervous System Agents, 1(2), 171-199.
- Pain Res Manag. 2006 Winter; 11(4): 245–247.
- Eur J Cancer Clin Oncol. 1989:25 Suppl 1:S15-9.
- Ondansetron. Drugs 52, 773–794 (1996).
- Pain Res Manag. 2006 Winter; 11(4): 245–247.
- Paediatr Child Health. 2011 Mar; 16(3): 177–179.
FAQs
Is Ondansetron a steroid?
It is not a steroid medication; rather, it is an antiemetic (anti-nausea) medication. It is a member of the class of drugs known as 5-HT3 receptor blockers.
Is Ondansetron a narcotic?
Ondansetron belongs to a class of drugs called serotonin antagonists., whereas narcotic is a term used to describe opioids, which are a class of drugs used to treat pain.
What is the half-life of Ondansetron?
The half-life of ondansetron varies with age: adults have a 3.5 to 5.5 hour half-life, while children aged 5 to 12 have a 3 to 5.5 hour half-life.
Where is Ondansetron’s site of action?
Ondansetron antagonizes 5-HT3 receptors at two distinct locations: (i) centrally, in the postrema/NTS area; and (ii) peripherally, on vagus nerve terminals.
How soon does an Ondansetron work?
This medication takes 30 minutes to 2 hours to start working.
Is Ondansetron FDA approved?
Ondansetron is U.S. FDA-approved for preventing postoperative, chemotherapy-induced, and radiotherapy-induced nausea and vomiting. Approval Date: 10/31/1997.
Is Ondansetron be taken for pregnancy morning sickness?
Pregnancy-related nausea and vomiting (NVP) symptoms have also been treated with ondansetron prescriptions.
What is the ondansetron pH limit?
Ondansetron is soluble in water in acidic environments and is a weak basic (pKa = 7.4). Ondansetron hydrochloride solutions have a natural pH of 4.5 to 4.6. In solutions with pH values greater than or equivalent to 6, the solubility is noticeably decreased.
How does Ondansetron work?
Ondansetron being a 5-HT3 receptor antagonist, works by blocking the action of serotonin.
Is Ondansetron used for anxiety?
Primarily, Ondansetron is used for treating nausea & emesis (vomiting); it has been shown to be successful in reducing anxiety in some clinical trials. According to research by Harmer et al. (2006), ondansetron eliminates startle responses in humans caused by emotions.