Does Zofran (ondansetron) interact with telmisartan HCT (hydrochlorothiazide), Symbicort (budesonide/formoterol), Augmentin (amoxicillin/clavulanate), or Ciprodex (ciprofloxacin/dexamethasone) otic drops?

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Last updated: November 6, 2025View editorial policy

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Drug Interactions Between Zofran and Your Medications

Zofran (ondansetron) does not have clinically significant interactions with telmisartan/HCTZ, Symbicort, Augmentin, or Ciprodex otic drops, and can be safely used concurrently with all of these medications.

Interaction Analysis by Medication

Telmisartan/HCTZ (Telmisartan-Hydrochlorothiazide)

  • No interaction exists between ondansetron and telmisartan/HCTZ 1.
  • Telmisartan is not metabolized by the cytochrome P450 enzyme system, which eliminates the primary pathway for drug-drug interactions 1.
  • Ondansetron does not affect blood pressure medications or diuretics through any known mechanism 2.
  • No dosage adjustment is recommended when telmisartan is combined with other pharmacological agents 1.

Symbicort (Budesonide/Formoterol)

  • No interaction occurs between ondansetron and inhaled corticosteroids or long-acting beta-agonists 3, 4.
  • Ondansetron's most common adverse events are headache and constipation, not respiratory effects 3.
  • The inhaled route of Symbicort results in minimal systemic absorption, further reducing any potential interaction risk 3.

Augmentin (Amoxicillin/Clavulanate)

  • No interaction exists between ondansetron and amoxicillin/clavulanate 5.
  • These medications have been studied together in pediatric populations without any reported drug interactions 5.
  • Ondansetron is commonly used to manage nausea in patients taking antibiotics, including amoxicillin-based regimens 4.
  • The main adverse effect of Augmentin is diarrhea (19.5% incidence), which is unrelated to ondansetron use 5.

Ciprodex Otic Drops (Ciprofloxacin/Dexamethasone)

  • No systemic interaction occurs with topical otic ciprofloxacin/dexamethasone 6, 5.
  • Topical quinolone drops are not absorbed systemically, unlike oral quinolones 6.
  • The otic route delivers medication directly to the ear canal and middle ear space without significant systemic circulation 6.
  • Ciprodex has been used safely in children receiving various systemic medications without reported interactions 5.

Key Clinical Points

Safety Profile

  • Ondansetron is generally well tolerated with a 36% overall incidence of adverse events, primarily mild headache and constipation 3.
  • None of your current medications appear on lists of drugs with significant cytochrome P450 interactions that would affect ondansetron metabolism 6.

Common Pitfalls to Avoid

  • Do not confuse systemic ciprofloxacin (oral/IV) with topical otic ciprofloxacin—only systemic quinolones have potential drug interactions 6.
  • Ondansetron does not require monitoring when combined with antihypertensives, antibiotics, or inhaled respiratory medications 3, 4.
  • The combination of ondansetron with dexamethasone (present in Ciprodex) is actually beneficial for antiemetic efficacy when used systemically, though the topical otic dose is too low for systemic effects 3, 4.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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