Introduction

This treatment plan reviews the risks and benefits of the treatment we are recommending. Please make sure to read it and the manufacturer's pamphlet that comes with the medicine. The manufacturer's pamphlet contains full information on potential medication interactions, side effects, and other important information you should know about the medicine before you start.

Instructions

The medication you have been prescribed is Zofran ODT 8mg (Ondansetron 8mg Oral Disintegrating Tablet), which you are to take one tablet by mouth three times daily as needed. This medication is used to prevent nausea and vomiting.

Please note that while Zofran is intended to help with nausea, it does not treat the underlying cause of your nausea. Should you also experience symptoms such as headaches, abdominal pain, or fever, it may indicate a more serious issue. We encourage you to see an in-person provider for further evaluation.

Patients with severe hepatic impairment should not exceed a total daily dose of 8mg (one tablet).

We are providing Zofran to help manage your symptoms. If you continue to experience symptoms, please follow up with your healthcare provider. Chronic issues can require ongoing care, and it's important to keep your provider informed to ensure you receive the best possible treatment.

Active Ingredient

Ondansetron hydrochloride dihydrate is equivalent to 8 mg of ondansetron. Each tablet also contains the inactive ingredients hypromellose, iron oxide yellow, lactose, magnesium stearate, microcrystalline cellulose, pregelatinized starch, triacetin, and titanium dioxide.

Allergies

This medicine, like all medications, may cause an allergic reaction if you are allergic to similar medicines or components.

Do not take Zofran ODT if you are allergic to ondansetron, alosetron (Lotronex), dolasetron (Anzemet), granisetron (Kytril), palonosetron (Aloxi, in Akynzeo), any other medications, or any of the ingredients in ondansetron products.

Phenylketonuric patients should be informed that Zofran ODT orally disintegrating tablets contain phenylalanine (a component of aspartame). Each 8-mg orally disintegrating tablet contains less than 0.03 mg phenylalanine.

Conditions

We have evaluated your health history and the specific health information you provided us, however, if you are actively taking any medications, or if anything changes and you develop one of these conditions, please stop taking this medicine and call or message us immediately:

• Pregnancy
• Hypersensitivity to 5-HT3 receptor antagonists
• QT interval prolongation
• Torsade de Pointes
• Serotonin syndrome
• Liver disease
• Progressive ileus and/or gastric distention following abdominal surgery or chemotherapy
• Phenylketonuria
  
  

Pregnancy and Breastfeeding

Studies did not find a higher chance of pregnancy loss, preterm delivery (delivery before 37 weeks of pregnancy), or low birth weight (weighing less than 5 pounds, 8 ounces [2500 grams] at birth) when ondansetron was used during pregnancy. A few studies reported a very small (less than 1%) increase in the chance for a cleft palate (an opening in the roof of the mouth that can be repaired with surgery) or a heart defect. Other factors that could affect the pregnancies exposed to ondansetron, such as the medical condition, could explain these results.

This medication is a pregnancy class B. We always recommend speaking with your OBGYN before taking any medication.

No adverse infant effects have been reported in women who received ondansetron postpartum in a pharmacokinetic study.

Use of ondansetron in nursing mothers beyond the immediate postpartum setting has not been studied well, but the drug is labeled for use in infants as young as 1 month of age. No special precautions are required. The developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Zofran ODT and any potential adverse effects on the breastfed infant from Zofran ODT or from the underlying maternal condition.

Some oral solution dosage forms may contain sodium benzoate/benzoic acid; benzoic acid (benzoate) is a metabolite of benzyl alcohol; large amounts of benzyl alcohol (≥99 mg/kg/day) have been associated with potentially fatal toxicity (“gasping syndrome”) in neonates; the “gasping syndrome” consists of metabolic acidosis, respiratory distress, gasping respirations, CNS dysfunction (including convulsions, intracranial hemorrhage), hypotension, and cardiovascular collapse.

Emergency Side Effects

This medicine can cause dangerous and potentially life-threatening side effects. If any of the emergency side effects listed in the manufacturer's pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in person:

• Blurred vision or vision loss
• Rash
• Hives, itching, or swelling of the face or extremities
• Chest pain
• Shortness of breath
• Dizziness, fainting, or confusion
• Palpitations or irregular heartbeat
• Fever
• Nausea, vomiting, urinary retention, or diarrhea
• Excessive sweating
• Loss of coordination, stiff or twitching muscles
• Seizures
• Coma
  
  

Medicines, Supplements, and Foods

We have evaluated the specific health information you provided us, however, if you are taking any of the medicines, foods, or supplements listed below call or message us before you take the medicine. Some of these can cause dangerous interactions with the medicine we are prescribing you and we will help you evaluate that risk and decide on an appropriate treatment plan. This list is not all-inclusive, so please make sure to inform us of any medications and supplements that you’re actively taking:

• 5-HT3 receptor antagonists and other serotonergic drugs, SSRIs and SNRIs
• medications for seizures such as carbamazepine (Carbatrol, Epitol, Equetro, Tegretol) or phenytoin (Dilantin)
• clarithromycin (Biaxin, in Prevpac)
• erythromycin
• fentanyl
• lithium
• medications to treat migraines such as almotriptan (Axert), eletriptan (Relpax), frovatriptan (Frova), naratriptan (Amerge), rizatriptan (Maxalt), sumatriptan (Imitrex), and zolmitriptan (Zomig)
• methylene blue
• mirtazapine (Remeron)
• monoamine oxidase (MAO) inhibitors including isocarboxazid (Marplan), linezolid (Zyvox), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelapar), and tranylcypromine (Parnate)
• moxifloxacin
• apomorphine
  
  

Accurate Information

We have evaluated the specific health information you provided and are making our recommendations based on it. If you forgot to provide or incorrectly provided that information we may misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. If you need to clarify or update any information about your health you can message or call us anytime.

Treatment Failure

This treatment is not guaranteed to be effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency, call 911 or seek immediate medical help in person.

Misdiagnosis or Delayed Diagnosis

Through telehealth, there is also a risk that we misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. This risk exists with a doctor in person as well but they may have additional resources to aid their evaluation. We use evidence-based practice and guidelines as well as clinical decision-making to minimize these risks.

Accepting or Declining Our Recommendation

We are recommending this treatment for you because the potential benefits outweigh the risks in your case based on the information you provided. You should evaluate this information as well as the manufacturer's pamphlet, any input from your in-person healthcare team, and any other relevant information to decide if this treatment plan is appropriate for you. You are free to not follow our recommendations although there may also be risks associated with no treatment.

Alternative Treatment

We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can't provide. Message us or talk to your doctor in person to discuss alternative treatments.

Share with Your In-Person Healthcare Team

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.

You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.