Is Zofran contraindicated with prolonged QT?
The antinausea drug ondansetron (Zofran) will carry a new warning about the risk of abnormal heart rhythms, the FDA announced last week.
How much does ondansetron prolong QTc?
A prospective, observational study in 40 cardiac patients (heart failure or ACS) found that ondansetron 4 mg IV prolonged the QTc interval by 19 msec for up to 2 hours after the dose (Hafermann, Drug Healthc Patient Safety 2011).
How common is QT prolongation with Zofran?
According to gender-related thresholds, the incidence of QTc prolongation was 20% and 23% in the ondansetron and droperidol groups, respectively. The investigators found a significant increase in mean QTc interval during the 15 minutes after antiemetic drug administration in both groups.
Which antiemetic is safe in QTc prolongation?
Therefore, clinicians should be familiar with antiemetic classes that can be safely used in patients who have an established prolonged QTc. Scopolamine is an antimuscarinic mediation with a similar anticholinergic side effect profile as antihistamines.
Can ondansetron cause long QT?
Of the 22 patients included in the final analysis, ondansetron administration was associated with an increase in the QT interval by 20 ms (95% CI, 14.0 mg to 26 mg; p<0.0001). A pairwise analysis similarly demonstrated a significant prolongation of the QT interval at 6, 12, and 14 minutes.
What are the contraindications of ondansetron?
Contraindications. Ondansetron is contraindicated in patients: known to have hypersensitivity (e.g., anaphylaxis) to Ondansetron or any of the components of the formulation [see Adverse Reactions (6.2)] receiving concomitant apomorphine due to the risk of profound hypotension and loss of consciousness.
When should you not give ondansetron?
Ondansetron is not approved for use by anyone younger than 4 years old. Ondansetron orally disintegrating tablets may contain phenylalanine. Tell your doctor if you have phenylketonuria (PKU).
Does ondansetron have a black box warning?
Side Effects In 2012, the FDA issued a black box warning, stating Ondansetron may increase the risk of developing prolongation of the QT interval of the electrocardiogram, which can lead to an abnormal and potentially fatal heart rhythm.
Can heart patient take ondansetron?
The FDA previously noted cardiovascular safety concerns that suggested Zofran (ondansetron) could cause QT prolongation, which can lead to a serious and sometimes fatal heart rhythm called Torsade de Pointes.
Can ondansetron cause heart problems?
Common Side Effects Headache and drowsiness are the drug’s most frequent side effects. Abnormal Heart Rhythms Zofran can cause QT interval prolongation and a potentially fatal heart rhythm called torsades de pointes.
What does Zofran do to the heart?
Ondansetron may increase the risk of developing abnormal changes in the electrical activity of the heart, which can result in a potentially fatal abnormal heart rhythm. Used to prevent nausea and vomiting caused by cancer chemotherapy, radiation therapy and surgery.
What antiemetic does not prolong QT?
palonosetron. Palonosetron is a second-generation 5HT3 antagonist, with the following advantages compared to ondansetron: Absence of QT prolongation (perhaps the greatest advantage). (26111957)
Can ondansetron affect heart rhythm?
Is Zofran safe for heart patients?
Does ondansetron affect the heart?
What medications increase QT interval?
Drugs Causing QT Prolongation
- Chlorpromazine.
- Haloperidol.
- Droperidol.
- Quetiapine.
- Olanzapine.
- Amisulpride.
- Thioridazine.
Which antiemetic is better for prolonged QT?
The final category of QTc-prolonging antiemetics is the serotonin receptor antagonists. These include ondansetron and its derivatives; granisetron, dolasetron, and palonosetron. Serotonin receptor antagonists are considered the cornerstone of antiemetic management in patients undergoing chemotherapy (7).
Which antidepressants cause QT prolongation?
– Use of >1 QT prolonging medicine – Medicines that inhibit the metabolism of another QT prolonging medicine – Medicines that cause electrolyte abnormalities or may cause renal or hepatic dysfunction
Which psychotropics carry the greatest risk of QTc prolongation?
There are limited data that selective serotonin reuptake inhibitors (SSRIs) as a class are linked to QTc prolongation; citalopram appears more likely than others to induce this phenomenon. Among antipsychotics, thioridazine remains the agent most associated with QTc prolongation; intravenous haloperidol also appears to carry an increased risk.
Which antiemetics cause QT prolongation?
Typical (First-Generation) Antipsychotics: The typical antipsychotics associated with the greatest risk of QTc prolongation are thioridazine, haloperidol, chlorpromazine, and pimozide.