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This document outlines critical safety information and warnings related to the use of ondansetron (Zofran). It is essential to understand these risks and consult your healthcare provider if you have questions or concerns.

• Severe Allergic Reactions: Ondansetron (Zofran) may cause serious allergic reactions, including facial swelling, hives, and anaphylaxis, which can be life-threatening. Seek immediate medical help if you experience symptoms such as dizziness, rapid heartbeat, difficulty breathing, or swelling of the face, lips, or tongue.

• Abnormal Heart Rhythm (QT Prolongation): This medication can cause QT prolongation, a potentially life-threatening heart rhythm disorder. Your risk increases if you have low blood potassium or magnesium levels, existing heart problems, or take other QT-prolonging drugs like amiodarone or ciprofloxacin. Symptoms like chest pain, shortness of breath, or fainting should be treated as emergencies. Regular heart monitoring through EKGs may be recommended by your healthcare provider.

• Serotonin Syndrome: Use of ondansetron (Zofran) can lead to serotonin syndrome, a rare but serious condition due to excessive serotonin. This risk is higher if combined with drugs that also elevate serotonin levels, such as certain antidepressants and migraine medications.

• Heart Attack Risk: There have been cases of heart attacks associated with ondansetron (Zofran), especially following the injection form. If you experience chest pain, arm pain, or shortness of breath, seek emergency assistance immediately.

• Masking of Gastrointestinal Issues: Ondansetron (Zofran) may conceal symptoms of intestinal blockage or bloating, especially in individuals post-surgery or undergoing chemotherapy. Notify your doctor if you experience difficulty passing stools or gas.

• Caution for Phenylketonuria (PKU) Patients: The orally disintegrating tablets of ondansetron (Zofran) contain phenylalanine. Individuals with PKU should inform their healthcare provider to explore safer alternatives.

• Contraindications: Do not use ondansetron (Zofran) if you are taking apomorphine (Apokyn), as it may cause critically low blood pressure and loss of consciousness.

Always discuss your medical history and any current medications with your healthcare provider to ensure ondansetron (Zofran) is safe for you.

Common side effects:

• Headaches
• Fatigue
• Constipation
• Diarrhea
• Dizziness
• Anxiety

Less common but important to monitor:

• Itchy skin
• Rash

Serious side effects:

• Severe allergic reactions (hives, difficulty breathing, swelling of face, lips, tongue, or throat)
• Abnormal heart rhythms (pounding chest, irregular heartbeat, chest pain, shortness of breath, feeling faint)
• Serotonin syndrome (fast heart rate, dizziness, sweating, muscle stiffness or twitching, uncoordinated movements, distress, hallucinations)

Interactions with high risk of serious adverse effects and should be avoided:

• Apomorphine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Tramadol
• MDMA ("ecstasy")
• St. John's wort
• Fluoxetine
• Paroxetine
• Duloxetine
• Venlafaxine