ZofranOndansetrona
How it works
Blocks serotonin (5-HT3) receptors in the chemoreceptor trigger zone. Prevents both acute and delayed nausea/vomiting.
Backbone antiemetic for chemo. Give on schedule (not as-needed) for best efficacy. Max 8 mg per dose (QT risk at > 16 mg/day). Add olanzapine or aprepitant for breakthrough nausea per MASCC/ESMO 2023.
Dosing
Typical doses
- 4–8 mg PO BD–TID
- 8 mg IV on chemo day
Schedule
- D1–D3 of chemo cycle (scheduled, not PRN)cycle_linked
Side Effects
- •Headache
- •Constipation (opioid-like effect on bowel)
- •Dizziness, lightheadedness
- QT prolongation (rare, usually benign)