From the FDA Drug Label
with or without gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea)
- The FDA drug label mentions that ondansetron can cause nausea and vomiting as part of gastrointestinal symptoms, but it does not explicitly state that vomiting can be worsened by zofran (ondansetron) 1.
- However, it does mention that ondansetron tablets are not a drug that stimulates gastric or intestinal peristalsis and should not be used instead of nasogastric suction, implying that it may not always be effective in preventing or treating vomiting.
- Additionally, the label mentions that the use of ondansetron tablets in patients following abdominal surgery or in patients with chemotherapy-induced nausea and vomiting may mask a progressive ileus and/or gastric distension, which could potentially worsen vomiting in some cases 1.
- Given the available information, it is unclear whether ondansetron can worsen vomiting, and a conservative clinical decision would be to monitor patients closely for signs of worsening vomiting when using ondansetron 1.
From the Research
If vomiting is worsened by Zofran (ondansetron), you should stop taking it and contact your healthcare provider immediately for an alternative medication. This paradoxical reaction is uncommon but can occur. Your doctor might recommend a different antiemetic such as promethazine (Phenergan), prochlorperazine (Compazine), or metoclopramide (Reglan) instead, as suggested by 2. While waiting for medical advice, try small sips of clear fluids to prevent dehydration, and consider non-medication approaches like ginger tea or peppermint. The worsening of symptoms may be due to individual sensitivity to ondansetron or its 5-HT3 receptor antagonist mechanism not being appropriate for your specific cause of nausea. Some patients experience increased gastrointestinal motility with Zofran, which can paradoxically worsen symptoms in certain conditions.
According to a recent study 3, ondansetron is effective in preventing postoperative nausea and vomiting, but its efficacy may vary depending on the individual and the cause of nausea. The study found that ondansetron was more effective than placebo in preventing vomiting, but its effectiveness was lower compared to other antiemetics such as aprepitant and ramosetron.
If vomiting is severe or persistent, seek immediate medical attention as dehydration can develop quickly and may require IV fluids and alternative treatments. It is essential to note that the management of nausea and vomiting should be guided by the underlying cause, and the choice of antiemetic should be based on the individual's specific needs and medical history, as recommended by 2.
In terms of alternative treatments, a study 4 found that domperidone was less effective than ondansetron in treating acute gastroenteritis-associated vomiting in young children. However, another study 5 found that ondansetron was more effective than metoclopramide in preventing chemotherapy-induced nausea and vomiting.
Overall, the management of vomiting worsened by Zofran requires a comprehensive approach that takes into account the individual's specific needs and medical history, and may involve the use of alternative antiemetics and non-medication approaches.