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Ondansetron may mask a progressive ileus and/or gastric distension in patients undergoing abdominal surgery or in patients with chemotherapy and/or radiotherapy-induced nausea and vomiting.
Ondansetron does not stimulate gastric or intestinal peristalsis so should not be used as a substitute for nasogastric suction.
The drug should be used with caution and at reduced dosage in patients with moderate to severe hepatic impairment.
Ondansetron may cause serious hypersensitivity reactions. Patients should be advised to monitor these reactions including urticaria, angioedema, hypotension, bronchospasm and labored respiration. If rash or any reactions occur, discontinue drug use and consult physicians. In addition, hypersensitivity can occur in patients who are allergic to other selective 5-HT3 receptor antagonists.
Injection: Transient ECG changes (including QT interval prolongation) have been reported (rarely) with IV use.
Ondansetron injection should not be mixed with solutions for which physical and chemical compatibility have not been established. In particular, this applies to alkaline solutions, as a precipitate may form.
Use in the Elderly: Dose selection for elderly patients should be cautious, usually starting at the low dose, and it may be useful to monitor closely. Because they are more likely to have decreased hepatic, renal or cardiac function.
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