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Zofran: the must-have that's
missing from your medicine cabinet

By Alexis Ross, PA-C
May 15, 2023

Medically reviewed by Alexis Ross, PA-C

Have you ever experienced nausea, or even worse, vomiting, when starting a new medication? It’s an extremely common side effect of supplements, antibiotics, and hormonal treatments that can keep you from completing your full course of important medications! There’s one reliable treatment that nurses and doctors keep in their medicine cabinets to knock out nausea fast—Zofran. Here’s what you need to know.

What is Zofran?

Zofran, also known by the generic name Ondansetron, is an FDA-approved medication used to help with the nausea and vomiting associated with cancer treatment, radiation, and that yucky feeling that’s common after a surgical procedure. Day to day, doctors can also prescribe it to help soothe stomach bug symptoms, stop pregnancy-related morning sickness, and reduce the side effects of medications like antibiotics and certain hormonal pills that can cause nausea. It’s so helpful to have on hand that Wisp medical advisor and clinician Alexis Ross always keeps it in her medicine cabinet. She says, “For patients who do not have any risk factors for taking Zofran, it’s my go-to add-on to help alleviate some of the nausea that can ensue from BV antibiotics like Metronidazole, or Norethindrone Acetate. What's most important is that our patients' side effects are minimized so that they can complete their medication as directed!”

How does Zofran work?

Certain medications that we use to treat Bacterial Vaginosis and UTIs, or [Delay Your Period(blog/is-it-safe-to-delay-your-period), can cause mild nausea as one of the main side effects. To help combat these side effects, we now offer Zofran as an add on to purchase with your meds! You can take one Zofran tablet 30 minutes before your prescribed dose of medication, which allows for enough time for the Zofran to kick in and prevent those uncomfortable waves of nausea. Keep in mind that the maximum dose of Zofran is one pill, three times daily every 8 hours. Taking Zofran with antibiotics, for example, can help you reduce your side effects so you can finish your medication and prevent your infection from returning.

How long does it take Zofran to take effect?

Wisp offers Zofran ODT (oral disintegrating tablets). These tablets dissolve on your tongue which makes them fast-acting—they can take as little as 30 minutes to start working, and will reach their full effect after about 2 hours. It’s for this exact reason that we recommend taking Zofran before you expect nausea (if possible), so that there is enough time for it to fully start working when you need it most!

Does Zofran have side effects?

Side effects with Zofran are rare, but it is possible to experience mild side effects such as:

  • Constipation
  • Headache
  • Drowsiness
  • Diarrhea

One important benefit is that Zofran can be taken with or without food! It can be hard to eat when you are feeling nauseous, so don’t feel pressure to eat before taking it. You will tolerate it just fine!

Who shouldn’t take Zofran?

While Zofran is generally well tolerated, and extremely helpful when experiencing nausea after starting a new medication, there are some drug interactions you’ll want to watch for.

Zofran is a serotonin receptor blocker—if serotonin receptors are blocked, there will be more serotonin circulating around your body. An increase in circulating serotonin can be dangerous because there are other medications that allow for increased serotonin in your body—medications that help with anxiety, depression (SSRI’s), migraine medications (Triptans), and antibiotics like Linezolid. If you are on one of the mentioned medications while taking Zofran, you may be putting yourself at risk for Serotonin Syndrome, a condition that occurs when your serotonin levels are dangerously high. This syndrome can have mild symptoms such as experiencing shakiness, trouble sleeping, excessive sweating. More extreme symptoms are high fever, uncontrollable diarrhea, and uncontrollable shaking and body movements. Of note, if any of those side effects are to occur while taking Zofran, please stop taking the medication and seek medical attention immediately.

Additionally, while Cardiac side effects are definitely rare with Zofran, there are some reports of QT elongation when taking this medication, which is quite dangerous causing the heart to take longer to contract and relax. Who is at risk for this? Those who are taking antiarrhythmic medication, people with low potassium or magnesium levels, those who take antibiotics from the Fluroquinolone family (Ciprofloxacin, levaquin), or Macrolide family (Azithromycin).

If you have a history of the below mentioned conditions, you should speak to your medical provider before taking Zofran:

  • Heart disease
  • History of irregular heartbeat
  • Liver disease
  • Low levels of magnesium or potassium in the blood
  • An unusual or allergic reaction to ondansetron, granisetron, other medications, foods, dyes, or preservatives
  • Pregnant or trying to get pregnant
  • Anxiety/depression and on SSRI’s
  • History of PKU
  • Breast-feeding

We’re thrilled to be able to offer this medication that can help make treatment that much easier. Next time you’re checking out with antibiotics or Norethindrone Acetate, consider adding on Zofran to help reduce nausea and keep your recovery smooth.

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