Can a dissolvable Zofran (ondansetron) tablet be cut in half?

Cutting Zofran (Ondansetron) Dissolvable Tablets

No, you should not cut dissolvable Zofran (ondansetron) tablets in half as this may compromise the medication's integrity and accurate dosing.

Rationale for Not Splitting Dissolvable Zofran

Formulation Considerations

• Ondansetron is available in various formulations including oral dissolving tablets that are specifically designed to disintegrate quickly in the mouth 1, 2
• Dissolving tablets have specific formulations that ensure proper drug delivery and absorption
• Cutting these tablets may:
  • Disrupt the tablet's dissolution properties
  • Lead to inaccurate dosing
  • Result in medication fragments or powder loss

Dosing Accuracy Concerns

• Tablet splitting can result in uneven drug distribution and inconsistent dosing 3
• Studies have shown that 15-16% of split tablets fall outside acceptable weight and drug content uniformity specifications 3
• For medications like ondansetron where precise dosing is important for efficacy, maintaining tablet integrity is essential

Available Alternatives

• Ondansetron is available in multiple strengths and formulations that eliminate the need for splitting:
  • Standard oral tablets: 8 mg
  • Oral dissolving tablets: 8 mg
  • Oral soluble films: 8 mg
  • Injectable solution: 8 mg or 0.15 mg/kg IV 1, 2

Clinical Recommendations

For Patients Requiring Lower Doses

• Request an appropriate lower-dose formulation from your healthcare provider
• Consider alternative antiemetics if appropriate for your condition
• Discuss with your pharmacist about availability of liquid formulations if swallowing is an issue

For Healthcare Providers

• Prescribe the appropriate strength of ondansetron based on patient needs
• Consider the following alternatives when lower doses are needed:
  • Prescribe a lower strength tablet if available
  • Consider liquid formulations
  • Evaluate alternative antiemetics in the same class (e.g., granisetron) if appropriate

Safety Considerations

• Ondansetron has a potential for QT interval prolongation at higher doses 4
• Accurate dosing is important for both efficacy and safety
• The FDA has advised against tablet splitting in general due to dosing accuracy concerns 5
• Computerized decision support systems have been implemented in some settings to reduce inappropriate tablet splitting 6

Remember that ondansetron should be administered 30 minutes before chemotherapy or radiation therapy for optimal effect 7, and maintaining the integrity of the tablet ensures proper absorption and therapeutic effect.