This information is intended for general knowledge and informational purposes only, and does not constitute medical advice. It is essential to consult with a licensed healthcare provider for personalized medical advice, diagnosis, and treatment. Mind Your Own Rx’s services provide an online consultation with a licensed physician who will assess your specific health needs and determine if a prescription is appropriate for you. Do not self-diagnose or self-medicate based on this information.

Ondansetron (Zofran)

Ondansetron, often known by its brand name Zofran, is a prescription drug primarily used to prevent nausea and vomiting. Dosage and administration of Ondansetron should always be as directed by your prescribing physician. The specific dosage can vary significantly based on the condition being treated, such as chemotherapy-induced, radiation-induced, or post-operative nausea, or general nausea. It can be taken either with or without food. It is crucial to always follow the specific dosage instructions provided by your doctor during your consultation.

Regarding warnings and precautions, you should not use Ondansetron if you are allergic to ondansetron or any of its ingredients. It is vital to inform your doctor if you have a history of heart problems, including conditions like irregular heartbeat (QT prolongation), heart failure, or imbalances of electrolytes such as potassium or magnesium. A rare but serious condition known as Serotonin Syndrome can occur, with an increased risk if Ondansetron is taken concurrently with other medications that increase serotonin levels (e.g., certain antidepressants like SSRIs/SNRIs). Seek immediate medical attention if you experience symptoms such as agitation, hallucinations, rapid heart rate, fever, muscle rigidity, or severe nausea, vomiting, or diarrhea. Exercise caution if you have significant liver impairment, as dosage adjustments may be necessary. If using orally disintegrating tablets (ODT), be aware they may contain phenylalanine, which is relevant for individuals with Phenylketonuria (PKU). Concurrent use with apomorphine is contraindicated due to a heightened risk of severe low blood pressure and loss of consciousness.

Common side effects associated with Ondansetron may include headache, constipation, diarrhea, fatigue or weakness, dizziness or lightheadedness, and dry mouth. More serious side effects require immediate medical attention. Seek immediate medical attention if you experience chest pain, shortness of breath, an irregular heartbeat, severe dizziness or fainting, or any signs of an allergic reaction such as a rash, hives, itching, difficulty breathing or swallowing, or swelling of the face or throat. Additionally, be alert for symptoms of Serotonin Syndrome as previously listed.

When considering drug interactions, it is imperative to inform your doctor of all medications you are currently taking, including other prescription drugs, over-the-counter medications, vitamins, and herbal supplements. Particular attention should be paid to Apomorphine, which is contraindicated for concurrent use. Caution is also advised with medications that prolong the QT interval (e.g., certain antiarrhythmics, antipsychotics) and serotonergic drugs (e.g., SSRIs, SNRIs, MAOIs, tricyclic antidepressants, fentanyl, lithium, tramadol, triptans). Certain drugs like Phenytoin, Carbamazepine, and Rifampicin may decrease Ondansetron levels in the body.

Regarding pregnancy and breastfeeding, always tell your doctor if you are pregnant, plan to become pregnant, or believe you might be pregnant. Ondansetron should be used during pregnancy only if it is clearly needed. It is not currently known whether Ondansetron passes into breast milk, so you should discuss this with your doctor if you are breastfeeding or planning to breastfeed.

Metoclopramide

Metoclopramide is a prescription drug utilized to treat nausea and vomiting, and to alleviate symptoms associated with gastroparesis, a condition characterized by slow stomach emptying. General guidance for dosage and administration indicates it is typically taken as directed by your prescribing physician, often 30 minutes before meals and at bedtime. It is crucial to always follow the specific dosage instructions provided by your doctor during your consultation.

Metoclopramide carries a Black Box Warning due to the risk of Tardive Dyskinesia (TD), a serious and often irreversible movement disorder. The risk of developing TD increases with the duration of treatment and the total cumulative dose, therefore treatment duration should generally not exceed 12 weeks. Do not use Metoclopramide if you are allergic to it or any of its ingredients. It is contraindicated if you have a stomach or intestinal obstruction, bleeding, or perforation. Use with caution if you have a history of epilepsy or seizures, as it may increase seizure frequency. This medication should not be used in patients diagnosed with pheochromocytoma, an adrenal gland tumor, due to the risk of a hypertensive crisis. It may also worsen symptoms of Parkinson’s disease and can potentially cause or exacerbate depression. A rare but serious condition, Neuroleptic Malignant Syndrome (NMS), can occur, presenting with symptoms such as high fever, muscle rigidity, altered mental status, and irregular pulse or blood pressure; seek immediate medical attention if these symptoms arise.

Common side effects associated with Metoclopramide can include drowsiness, fatigue, restlessness, agitation, headache, dizziness, nausea, diarrhea, and insomnia. More serious side effects warrant immediate medical attention. Seek immediate medical attention if you experience symptoms of Tardive Dyskinesia, such as involuntary movements of the face (e.g., lip smacking, grimacing, blinking), tongue (e.g., thrusting, protrusion), or limbs. Also, be alert for symptoms of Neuroleptic Malignant Syndrome as previously described, Parkinsonian-like symptoms like tremors or stiffness, a severe allergic reaction (rash, itching, swelling, severe dizziness, trouble breathing), or the development of depression or suicidal thoughts.

For drug interactions, it is essential to inform your doctor of all medications you are currently taking, including other prescription drugs, over-the-counter medications, vitamins, and herbal supplements. Anticholinergic drugs (e.g., atropine) and opioid analgesics may reduce Metoclopramide’s effects. Concurrent use with alcohol and other CNS depressants (e.g., sedatives, hypnotics, opioids, antipsychotics) can lead to increased sedation. Dopamine agonists (e.g., bromocriptine, cabergoline) may have their effects antagonized by Metoclopramide. There is an increased risk of side effects when taken with MAOIs. Caution is advised with other drugs that prolong the QT interval. For diabetic patients, insulin dosage adjustments may be necessary due to altered food absorption.

Regarding pregnancy and breastfeeding, always inform your doctor if you are pregnant, plan to become pregnant, or think you might be pregnant. Metoclopramide should only be used during pregnancy if it is clearly needed. Metoclopramide is known to pass into breast milk, so you should discuss the potential risks and benefits with your doctor if you are breastfeeding or planning to breastfeed.