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Ondansetron
Abstract:
Ondansetron is the first selective antagonist of the 5-hydroxytryptamine receptors (type 3) marketed for the prevention of emesis induced by antineoplastic agents. Ondansetron has been shown to be more active and less toxic than high-dose metoclopramide in patients submitted to cisplatin chemotherapy. Furthermore, when dexamethasone was added to ondansetron, its antiemetic efficacy increased significantly. In the prevention of emesis induced by a high single dose of cisplatin or by repeated low doses, ondansetron combined with dexamethasone has been shown to be the more efficacious and less toxic antiemetic treatment. However, in the prevention of delayed emesis from cisplatin, its role is still to be defined. In patients submitted to moderately emetogenic chemotherapeutic agents, ondansetron has shown an efficacy superior or equal to standard doses of metoclopramide, but is less toxic. Moreover, when compared with dexamethasone, its antiemetic efficacy and tolerability is similar; in this group of patients ondansetron should be used only when steroids fail. Ondansetron toxicity is generally mild; in particular, it does not induce extrapyramidal reactions. The most frequent side-effects are headache and constipation.
Insights
Ondansetron effectively prevents chemotherapy-induced nausea and vomiting, showing better results than metoclopramide and similar efficacy to dexamethasone. This antiemetic is well-tolerated, with mild side effects like headache and constipation.
Area of Science:
- Pharmacology
- Oncology
- Gastroenterology
Background:
- Ondansetron is a selective 5-hydroxytryptamine receptor 3 antagonist.
- It is used to prevent chemotherapy-induced emesis.
Purpose of the Study:
- To evaluate the efficacy and toxicity of ondansetron in preventing chemotherapy-induced nausea and vomiting.
- To compare ondansetron with metoclopramide and dexamethasone.
Main Methods:
- Clinical trials comparing ondansetron with other antiemetic agents.
- Assessment of antiemetic efficacy and toxicity profiles.
Main Results:
- Ondansetron is more active and less toxic than high-dose metoclopramide for cisplatin chemotherapy.
- Combining ondansetron with dexamethasone significantly increases antiemetic efficacy.
- Ondansetron shows superior or equal efficacy to metoclopramide for moderately emetogenic agents, with less toxicity.
- Ondansetron's role in delayed emesis prevention requires further definition.
Conclusions:
- Ondansetron, particularly combined with dexamethasone, is a highly effective and well-tolerated antiemetic for chemotherapy-induced nausea and vomiting.
- It offers a favorable alternative to metoclopramide and can be used when steroids fail.
- Mild side effects such as headache and constipation are most common.