{"id":7431,"date":"2025-06-06T16:50:48","date_gmt":"2025-06-06T16:50:48","guid":{"rendered":"https:\/\/healthmedicinet.com\/review\/hmn-ondansetron-interactions-to-avoid-in-2025\/"},"modified":"2025-06-06T16:50:48","modified_gmt":"2025-06-06T16:50:48","slug":"hmn-ondansetron-interactions-to-avoid-in-2025","status":"publish","type":"post","link":"https:\/\/healthmedicinet.com\/review\/hmn-ondansetron-interactions-to-avoid-in-2025\/","title":{"rendered":"HMN: Ondansetron interactions to avoid |   in 2025"},"content":{"rendered":"<p>\n<br \/>Do you know:  Ondansetron interactions to avoid |  in 2025<\/p>\n<div id=\"main-content\">\n<div id=\"post-intro\">\n<div id=\"takeaways\">\n<h2>Key takeaways<\/h2>\n<ul>\n<li>\n<p><span style=\"font-weight: 400;\">The most dangerous ondansetron interactions include consumption with other medications known to have serotonergic effects independently or have QT-prolonging potential.\u00a0<\/span><\/p>\n<\/li>\n<li>\n<p><span style=\"font-weight: 400;\">The combination of ondansetron with serotonergic medications can result in a serious condition known as serotonin syndrome.\u00a0<\/span><\/p>\n<\/li>\n<li>\n<p><span style=\"font-weight: 400;\">Concomitant use of ondansetron and medications known to cause long QT syndrome can result in cardiac conduction abnormalities, including life-threatening heart rhythm patterns like torsades de pointes.\u00a0<\/span><\/p>\n<\/li>\n<li>\n<p><span style=\"font-weight: 400;\">Other less serious drug interactions can occur between ondansetron and other prescription, over-the-counter (OTC), and supplements, which can result in side effects that may be managed or avoided altogether by avoiding the combination.\u00a0<\/span><\/p>\n<\/li>\n<li>\n<p><span style=\"font-weight: 400;\">In the event of a drug interaction with ondansetron, it is always best to seek immediate attention from a healthcare professional.<\/span><\/p>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n<section class=\"table-of-contents\">\n<div class=\"anchorLinks\">\n<div class=\"mobile-only\">\n<div class=\"dropdownLists\">\n<div tabindex=\"0\" class=\"dropdownBtn\"><span class=\"listsIcon\"><br \/>\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.singlecare.com\/blog\/wp-content\/themes\/singlecare\/images\/union.svg\" width=\"14\" height=\"20\"\/><\/span><br \/>\n\t\t\t\t\t\t\t<label><\/label><br \/>\n\t\t\t\t\t\t\t<span class=\"downArrow\"><br \/>\n\t\t\t\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.singlecare.com\/blog\/wp-content\/themes\/singlecare\/images\/dropDownArrow.svg\" width=\"24\" height=\"24\"\/><br \/>\n\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t<\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/section>\n<p><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\">, known under the <\/span><span style=\"font-weight: 400;\">brand name<\/span> <span style=\"font-weight: 400;\">Zofran<\/span><span style=\"font-weight: 400;\">, is a selective 5-HT3 <\/span><span style=\"font-weight: 400;\">receptor antagonist<\/span><span style=\"font-weight: 400;\"> that functions as an <\/span><span style=\"font-weight: 400;\">antiemetic<\/span><span style=\"font-weight: 400;\"> to aid in the prevention of nausea and vomiting from chemotherapy or <\/span><span style=\"font-weight: 400;\">radiation therapy<\/span><span style=\"font-weight: 400;\">, treatment of severe and acute nausea and vomiting and the prevention and treatment of postoperative nausea and vomiting. <\/span><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> is available as an injection, an oral solution, an oral tablet, and an <\/span><span style=\"font-weight: 400;\">orally-disintegrating tablet<\/span><span style=\"font-weight: 400;\">. <\/span><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> interactions with amiodarone, domperidone, methadone, specific antiarrhythmic and antibiotic medications, and serotonergic agents. <\/span><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> can also affect the metabolism of other medicines, exacerbating <\/span><span style=\"font-weight: 400;\">side effects<\/span><span style=\"font-weight: 400;\"> associated with individual drugs. It\u2019s important to be aware of <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> interactions as some of them can cause <\/span><span style=\"font-weight: 400;\">life-threatening<\/span><span style=\"font-weight: 400;\"> effects after a <\/span><span style=\"font-weight: 400;\">single dose<\/span><span style=\"font-weight: 400;\"> that warrant immediate medical attention.\u00a0<\/span><\/p>\n<h2 id=\"ondansetron-drug-interactions\"><span style=\"font-weight: 400;\">Ondansetron<\/span> <span style=\"font-weight: 400;\">drug interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The most serious medications that <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> interferes with include certain antiarrhythmics, antibiotics, and serotonergic medications.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Serotonergic Agents<\/span><\/p>\n<p><span style=\"font-weight: 400;\">As a <\/span><span style=\"font-weight: 400;\">selective 5HT3 <\/span><span style=\"font-weight: 400;\">receptor antagonist<\/span><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> blocks serotonin peripherally and centrally. Therefore, combining with other medications in the 5HT3 <\/span><span style=\"font-weight: 400;\">receptor antagonist<\/span><span style=\"font-weight: 400;\"> class will increase the potential risk.\u00a0<\/span><\/p>\n<p><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/depression\/in-depth\/maois\/art-20043992\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Monoamine oxidase <\/span><span style=\"font-weight: 400;\">inhibitors<\/span><\/a><span style=\"font-weight: 400;\">, or MAOIs, were the first class of antidepressants developed. These medications work by blocking an <\/span><span style=\"font-weight: 400;\">enzyme<\/span><span style=\"font-weight: 400;\">, monoamine oxidase, which removes serotonin from the brain. By inhibiting this <\/span><span style=\"font-weight: 400;\">enzyme<\/span><span style=\"font-weight: 400;\">, increased serotonin levels remain available to regulate, allowing feelings of focus, emotional stability, and overall happiness. Some MAOIs have additional indications, like selegiline used as adjunctive therapy for the management of Parkinson\u2019s disease. Other medications inhibit monoamine oxidase as a secondary mechanism to a primary, intended effect. Suppose any medication that inhibits monoamine oxidase is combined with serotonergic drugs like <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\">. In that case, the serotonergic effect of MAOIs can be enhanced, which could result in a serious medical condition known as <\/span><span style=\"font-weight: 400;\">serotonin syndrome<\/span><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">MAOIs include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Isocarboxazid (Marplan)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Phenelzine (Nardil)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Selegiline (Emsam)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Tranylcypromine (Parnate)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Additional medications that inhibit monoamine oxidase but are not antidepressants include:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other medications can enhance serotonin in the brain by different mechanisms. MAOIs affect serotonin by slowing its breakdown. They can also impact serotonin by blocking its reabsorption or directly stimulating serotonin receptors, either on purpose or as a secondary effect. Selective serotonin reuptake <\/span><span style=\"font-weight: 400;\">inhibitors<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">SSRIs<\/span><span style=\"font-weight: 400;\">), serotonin and norepinephrine reuptake <\/span><span style=\"font-weight: 400;\">inhibitors<\/span><span style=\"font-weight: 400;\"> (SNRIs), and tricyclic antidepressants (TCAs) intentionally raise serotonin levels. It is not advisable to combine medications that increase serotonin simultaneously due to the risk of <\/span><span style=\"font-weight: 400;\">serotonin syndrome<\/span><span style=\"font-weight: 400;\"> and <\/span><span style=\"font-weight: 400;\">toxicity<\/span><span style=\"font-weight: 400;\">. It is important to note that individuals may develop <\/span><span style=\"font-weight: 400;\">serotonin syndrome<\/span><span style=\"font-weight: 400;\"> and serotonin <\/span><span style=\"font-weight: 400;\">toxicity<\/span><span style=\"font-weight: 400;\"> on only a single serotonergic agent. Therefore, any onset of symptoms should be managed by immediate communication with a <\/span><span style=\"font-weight: 400;\">healthcare professional<\/span><span style=\"font-weight: 400;\">. The <\/span><a href=\"https:\/\/www.novartis.com\/us-en\/sites\/novartis_us\/files\/zofran.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">prescribing<\/span><span style=\"font-weight: 400;\"> information<\/span><\/a><span style=\"font-weight: 400;\"> for <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> notes that <\/span><span style=\"font-weight: 400;\">serotonin syndrome<\/span><span style=\"font-weight: 400;\"> and serotonin <\/span><span style=\"font-weight: 400;\">toxicity<\/span><span style=\"font-weight: 400;\"> have been reported with the use of 5HT3 antagonists alone or in combination with other serotonergic agents. Therefore, patients combining these <\/span><span style=\"font-weight: 400;\">prescription drugs<\/span><span style=\"font-weight: 400;\"> should be closely monitored for the emergence of these conditions.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Selective serotonin reuptake <\/span><span style=\"font-weight: 400;\">inhibitors<\/span><span style=\"font-weight: 400;\">, in addition to sertraline, include:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Citalopram (Celexa)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Escitalopram (Lexapro)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Paroxetine<\/span><span style=\"font-weight: 400;\"> (Paxil)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fluoxetine<\/span><span style=\"font-weight: 400;\"> (Prozac)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fluvoxamine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vilazodone<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Vortioxetine<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Serotonin and norepinephrine reuptake <\/span><span style=\"font-weight: 400;\">inhibitors<\/span><span style=\"font-weight: 400;\"> (SNRIs)<\/span><span style=\"font-weight: 400;\"> include:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Venlafaxine (Effexor)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Duloxetine (Cymbalta)<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Desvenlafaxine succinate (Pristiq)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Tricyclic antidepressants (TCAs)<\/span><span style=\"font-weight: 400;\"> include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Amitriptyline<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Clomipramine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Desipramine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Doxepin<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Imipramine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Lofepramine<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Nortriptyline<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Trimipramine<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Other medications with secondary serotonergic effects:<\/span><\/p>\n<p><span style=\"font-weight: 400;\">QT-prolonging Agents<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The <\/span><span style=\"font-weight: 400;\">QT interval<\/span><span style=\"font-weight: 400;\"> is the part of an electrocardiogram (EKG) report that represents the time it takes the heart to contract and recover. <\/span><a href=\"https:\/\/my.clevelandclinic.org\/health\/diseases\/17183-long-q-t-syndrome-lqts\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Long QT syndromes<\/span> <\/a><span style=\"font-weight: 400;\">can be inherited and are the result of an issue with the heart\u2019s electrical conduction such that it takes longer than normal to recharge between heartbeats, which is due to an issue with ion channels and the flow of ions (sodium, calcium, <\/span><span style=\"font-weight: 400;\">potassium<\/span><span style=\"font-weight: 400;\">, and chloride) in and out of heart muscle cells to produce electrical activity. Medications can also cause acquired <\/span><span style=\"font-weight: 400;\">long QT syndrome<\/span><span style=\"font-weight: 400;\">. When the <\/span><span style=\"font-weight: 400;\">QT interval<\/span><span style=\"font-weight: 400;\"> is prolonged, the risk for <\/span><span style=\"font-weight: 400;\">irregular heartbeats<\/span><span style=\"font-weight: 400;\"> like <\/span><span style=\"font-weight: 400;\">ventricular tachycardias<\/span><span style=\"font-weight: 400;\"> is increased, which can result in cardiac arrest and sudden death due to the heart\u2019s inability to pump blood throughout the body effectively.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Many medications can independently prolong the <\/span><span style=\"font-weight: 400;\">QT interval<\/span><span style=\"font-weight: 400;\">, including:\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Antiarrhythmic medications<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Class IA antiarrhythmics<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Disopyramide<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Procainamide<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Quinidine<\/span><\/li>\n<\/ul>\n<\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Class III antiarrhythmics<\/span>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Amiodarone<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Dofetilide<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Dronedarone<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Ibutilide<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"2\"><span style=\"font-weight: 400;\">Sotalol<\/span><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Antimicrobials<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ciprofloxacin<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Levofloxacin<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Ketoconazole<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Fluconazole<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Isavuconazole<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Posaconazole<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Itraconazole<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Voriconazole<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Antipsychotics<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> demonstrated a <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26720490\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">mean increase in the <\/span><span style=\"font-weight: 400;\">QT interval<\/span><\/a><span style=\"font-weight: 400;\"> from baseline by 20 milliseconds when given as 4 mg intravenously in the emergency department. Combining the use of other drugs known to prolong the QTc may further increase the risk for serious <\/span><span style=\"font-weight: 400;\">side effects<\/span><span style=\"font-weight: 400;\">, with at least <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/20394022\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">one study <\/span><\/a><span style=\"font-weight: 400;\">identifying the use of an additional QT-prolonging drug as the most common risk factor among patients with an identified <\/span><span style=\"font-weight: 400;\">QT prolongation<\/span><span style=\"font-weight: 400;\">. Patients prescribed <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\">, especially those at higher risk for cardiac abnormalities, such as those with <\/span><span style=\"font-weight: 400;\">heart failure<\/span><span style=\"font-weight: 400;\"> or electrolyte abnormalities (including blood <\/span><span style=\"font-weight: 400;\">potassium<\/span><span style=\"font-weight: 400;\"> and <\/span><span style=\"font-weight: 400;\">magnesium<\/span><span style=\"font-weight: 400;\"> levels), should be monitored with an EKG before receiving the <\/span><span style=\"font-weight: 400;\">first dose<\/span><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Apomorphine<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Apomorphine<\/span><span style=\"font-weight: 400;\"> is a <\/span><span style=\"font-weight: 400;\">dopamine agonist<\/span><span style=\"font-weight: 400;\"> used in the management of <\/span><span style=\"font-weight: 400;\">Parkinson\u2019s disease<\/span><span style=\"font-weight: 400;\">, often as adjunctive therapy with other anti-Parkinsonian agents. The combination of <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> and other 5HT3 antagonists, including <\/span><span style=\"font-weight: 400;\">granisetron<\/span><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">dolasetron<\/span><span style=\"font-weight: 400;\">, and palonosetron, are contraindicated with <\/span><span style=\"font-weight: 400;\">apomorphine<\/span><span style=\"font-weight: 400;\">, given the risk of enhanced hypotensive effects. The mechanism of the interaction remains unknown, but <\/span><a href=\"https:\/\/www.apokyn.com\/sites\/all\/themes\/apokyn\/content\/resources\/apokyn_pi.pdf\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">apomorphine<\/span> <span style=\"font-weight: 400;\">prescribing<\/span><span style=\"font-weight: 400;\"> information<\/span><\/a><span style=\"font-weight: 400;\"> reports cases of profound hypotension and resultant <\/span><span style=\"font-weight: 400;\">loss of consciousness<\/span><span style=\"font-weight: 400;\"> due to concomitant use of it with <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tramadol<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Tramadol<\/span><span style=\"font-weight: 400;\"> is an opioid analgesic employed in the management of moderate to severe pain. The combination of <\/span><span style=\"font-weight: 400;\">tramadol<\/span><span style=\"font-weight: 400;\"> and <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> may enhance the serotonergic effect of <\/span><span style=\"font-weight: 400;\">tramadol<\/span><span style=\"font-weight: 400;\">, increasing the risk of <\/span><span style=\"font-weight: 400;\">serotonin syndrome<\/span><span style=\"font-weight: 400;\"> or <\/span><span style=\"font-weight: 400;\">toxicity<\/span><span style=\"font-weight: 400;\">. In addition to this potential interaction, <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> may also decrease the therapeutic effect of <\/span><span style=\"font-weight: 400;\">tramadol<\/span><span style=\"font-weight: 400;\">. The presumed mechanism for this decreased analgesic effect between these two medications is thought to involve the antagonism of spinal 5HT3 receptors by <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\">, which is an effect in opposition to the actions of <\/span><span style=\"font-weight: 400;\">tramadol<\/span><span style=\"font-weight: 400;\">, which is suspected to exert some of its pain-relieving effects.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Metformin<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Metformin<\/span><span style=\"font-weight: 400;\"> is a very popular medication prescribed for the management of <\/span><span style=\"font-weight: 400;\">Type 2 diabetes mellitus<\/span><span style=\"font-weight: 400;\">. The combination of metformin with <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> may increase the blood levels of metformin, such that individuals on concomitant therapy must be monitored for metformin effects or <\/span><span style=\"font-weight: 400;\">toxicities<\/span><span style=\"font-weight: 400;\">. A <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/26825640\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">pharmacokinetic<\/span><span style=\"font-weight: 400;\"> study<\/span><\/a><span style=\"font-weight: 400;\"> of individuals receiving <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> daily demonstrated increased metformin exposure and maximum serum concentrations in 21% of individuals and decreased metformin renal elimination in 36% of participants. This has implications for individuals, including lower blood glucose levels, which can result in serious effects. The mechanism of this interaction is believed to be <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24001450\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">inhibition of specific transporters<\/span><\/a><span style=\"font-weight: 400;\"> in the body by <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\">, responsible for active renal elimination of metformin.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">CYP3A4 inducers<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Some <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> pharmacologic <\/span><span style=\"font-weight: 400;\">drug interactions<\/span><span style=\"font-weight: 400;\"> occur due to medications referred to as \u201cCYP3A4 inducers,\u201d-which are medications that increase the activity of a common <\/span><span style=\"font-weight: 400;\">enzyme<\/span><span style=\"font-weight: 400;\"> (<\/span><span style=\"font-weight: 400;\">cytochrome<\/span><span style=\"font-weight: 400;\"> P450) involved in the metabolism of many medications, including <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\">. CYP3A4 inducers are ubiquitous and rev up the <\/span><span style=\"font-weight: 400;\">enzyme<\/span><span style=\"font-weight: 400;\"> to varying degrees. Strong CYP3A4 inducers include <\/span><span style=\"font-weight: 400;\">anticonvulsant<\/span><span style=\"font-weight: 400;\"> medications like <\/span><span style=\"font-weight: 400;\">phenobarbital<\/span><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">phenytoin<\/span><span style=\"font-weight: 400;\">, and <\/span><span style=\"font-weight: 400;\">carbamazepine<\/span><span style=\"font-weight: 400;\">. These medications may <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10223773\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">decrease the blood levels of <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">but the changes are not considered clinically significant and do not warrant preemptive dose adjustments.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other strong CYP3A4 inducers include:\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Moderate CYP3A4 inducers include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Diltiazem<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Erythromycin<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Medications for fungal infections, such as fluconazole, isavuconazole, and posaconazole<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Letermovir<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">Verapamil<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">It\u2019s important to note that these lists are not all-inclusive. Always check with a <\/span><span style=\"font-weight: 400;\">healthcare professional<\/span><span style=\"font-weight: 400;\"> for any drug-<\/span><span style=\"font-weight: 400;\">drug interactions<\/span><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h2 id=\"ondansetron-food-interactions\"><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> food interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> may be absorbed slightly better when taken with food but can be taken without consideration in meals. Its <\/span><span style=\"font-weight: 400;\">adverse effects<\/span><span style=\"font-weight: 400;\"> may cause <\/span><span style=\"font-weight: 400;\">constipation<\/span><span style=\"font-weight: 400;\"> or diarrhea, which, coupled with its indication for nausea and vomiting, may preclude an ability to take with meals.\u00a0<\/span><\/p>\n<h2 id=\"other-ondansetron-interactions\"><span style=\"font-weight: 400;\">Other <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">In addition to <\/span><span style=\"font-weight: 400;\">prescription drugs<\/span><span style=\"font-weight: 400;\">, there are also <\/span><span style=\"font-weight: 400;\">side effects<\/span><span style=\"font-weight: 400;\"> to be aware of with products we may consume without awareness of potential interactions. Knowing how anything you put into your body can interact with another product is important.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> and alcohol\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">If you need to take <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\">, it\u2019s unlikely you\u2019re in the mood to drink alcohol. While there is no immediate interaction, <\/span><span style=\"font-weight: 400;\">side effects<\/span><span style=\"font-weight: 400;\"> of both may be exacerbated when combined with <\/span><span style=\"font-weight: 400;\">drowsiness<\/span><span style=\"font-weight: 400;\">, headache, and agitation. Some dosage forms of <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> contain sodium benzoate, a metabolite of benzyl alcohol. Large doses of benzyl alcohol have been associated with <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11487763\/\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">potentially fatal <\/span><span style=\"font-weight: 400;\">toxicity<\/span> <\/a><span style=\"font-weight: 400;\">in <\/span><span style=\"font-weight: 400;\">pediatrics<\/span><span style=\"font-weight: 400;\">, specifically neonates. Therefore, these formulations of <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> should be used with great caution in this population.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> and <\/span><span style=\"font-weight: 400;\">supplements<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Products readily available <\/span><span style=\"font-weight: 400;\">over the counter<\/span><span style=\"font-weight: 400;\"> may interact with prescription medications like <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\">. St. John\u2019s wort is a <\/span><span style=\"font-weight: 400;\">supplement<\/span><span style=\"font-weight: 400;\"> with serotonergic effects that could enhance the <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\">\u2018s serotonergic effects. The combination should be taken together with great caution.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> and <\/span><span style=\"font-weight: 400;\">Phenylketonuria<\/span><\/p>\n<p><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/phenylketonuria\/symptoms-causes\/syc-20376302\" target=\"_blank\" rel=\"noopener\"><span style=\"font-weight: 400;\">Phenylketonuria<\/span><\/a><span style=\"font-weight: 400;\">, a medical condition also known as PKU, is an uncommon inherited disorder that results in the accumulation of a specific amino acid called <\/span><span style=\"font-weight: 400;\">phenylalanine<\/span><span style=\"font-weight: 400;\"> due to a change in the gene that creates the <\/span><span style=\"font-weight: 400;\">enzyme<\/span><span style=\"font-weight: 400;\"> needed to break down <\/span><span style=\"font-weight: 400;\">phenylalanine<\/span><span style=\"font-weight: 400;\">. The buildup of this amino acid can result in long-term intellectual disabilities, so afflicted individuals must follow a diet that limits <\/span><span style=\"font-weight: 400;\">phenylalanine<\/span><span style=\"font-weight: 400;\">. <\/span><span style=\"font-weight: 400;\">Ondansetron<\/span><span style=\"font-weight: 400;\"> orally disintegrating (<\/span><span style=\"font-weight: 400;\">Zofran ODT<\/span><span style=\"font-weight: 400;\">) tablets contain <\/span><span style=\"font-weight: 400;\">phenylalanine<\/span><span style=\"font-weight: 400;\">, so its use must be avoided in those affected individuals living with <\/span><span style=\"font-weight: 400;\">phenylketonuria<\/span><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h2 id=\"how-to-minimize-ondansetron-interactions\"><span style=\"font-weight: 400;\">How to minimize <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Always carry a complete list of medications, including those that are <\/span><span style=\"font-weight: 400;\">non-prescription<\/span><span style=\"font-weight: 400;\">. Any time you\u2019re receiving <\/span><span style=\"font-weight: 400;\">medical advice<\/span><span style=\"font-weight: 400;\"> with new therapy recommendations, provide this list to help minimize the risk of <\/span><span style=\"font-weight: 400;\">drug interactions<\/span><span style=\"font-weight: 400;\">. When starting a new medication, reading the included <\/span><span style=\"font-weight: 400;\">drug information<\/span><span style=\"font-weight: 400;\"> and discussing any new signs or symptoms with your <\/span><span style=\"font-weight: 400;\">healthcare professional<\/span><span style=\"font-weight: 400;\"> is advisable, no matter how mild.\u00a0<\/span><\/p>\n<h2 id=\"when-to-talk-to-a-healthcare-provider-about-ondansetron-interactions\"><span style=\"font-weight: 400;\">When to talk to a <\/span><span style=\"font-weight: 400;\">healthcare<\/span><span style=\"font-weight: 400;\"> provider about <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> interactions<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">This article is only a partial list of <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> interactions. Be mindful of the risk of additive <\/span><span style=\"font-weight: 400;\">side effects<\/span><span style=\"font-weight: 400;\"> and direct <\/span><span style=\"font-weight: 400;\">drug interactions<\/span><span style=\"font-weight: 400;\">, which may occur when <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> is used in combination with prescription and <\/span><span style=\"font-weight: 400;\">over-the-counter<\/span><span style=\"font-weight: 400;\"> medications or <\/span><span style=\"font-weight: 400;\">supplements<\/span><span style=\"font-weight: 400;\">. Communicate directly with a <\/span><span style=\"font-weight: 400;\">healthcare professional<\/span><span style=\"font-weight: 400;\"> anytime you require <\/span><span style=\"font-weight: 400;\">ondansetron<\/span><span style=\"font-weight: 400;\"> so that a comprehensive review of interactions of both medications, diet, and conditions can occur to ensure a proper monitoring plan is put in place.\u00a0<\/span><\/p>\n<p><svg style=\"display:none\">\n  <g id=\"facebook\">\n    <rect width=\"32\" height=\"32\" rx=\"4\" fill=\"var(--social-bg)\"\/>\n    <path fill=\"var(--social-ico)\" d=\"M19.51 9.32003H21.39V6.14003C20.4798 6.04538 19.5652 5.99865 18.65 6.00003C15.93 6.00003 14.07 7.66003 14.07 10.7V13.32H11V16.88H14.07V26H17.75V16.88H20.81L21.27 13.32H17.75V11.05C17.75 10 18.03 9.32003 19.51 9.32003Z\"\/>\n  <\/g>\n  <g id=\"twitter\">\n    <rect width=\"32\" height=\"32\" rx=\"4\" fill=\"var(--social-bg)\"\/>\n    <path fill=\"var(--social-ico)\" d=\"M26 9.9506C25.2483 10.2767 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