The frequency of side effects is classified according to the recommendations of the parabolan: very often – at least 10%; often – at least 1% but less than 10%; infrequently – at least 0.1% but less than 1%; rare – less than 0.01% but less than 0.1%; very rarely – less than 0.01%, including isolated cases.
Allergic reactions: seldom – urticaria, bronchospasm, laryngospasm, angioedema, immediate hypersensitivity reactions, including anaphylaxis. From the nervous system: very often – headache; rarely – seizures, spontaneous movement disorders including extrapyramidal disorders (dystonic reactions, oculogyric crisis, dyskinesia), which are reversible and do not result in persistent clinical sequelae; rare – dizziness due to the rapid on / in the introduction. From a sight organ: seldom – a temporary reduction in visual acuity; very rarely – temporary blindness, mainly after / in the introduction. On the part of the cardiovascular system: rarely – pain in the chest, in some cases accompanied depression, arrhythmia, bradycardia, decreased blood pressure (BP); rarely – transient changes in the electrocardiogram , including lengthening of the interval , preferably with a / in the introduction.From the digestive system: often – constipation; infrequently – hiccup, dryness of the oral mucosa, diarrhea, transient increase in activity of “liver” transaminases. Other: often – a sense of warmth, “tides”, irritation, redness, pain, burning sensation at the injection site; rarely – hypokalemia, hypercreatininemia.
Symptoms: impaired vision parabolan (amaurosis within 2-3 min), constipation, reduced blood pressure and vasovagal syncope with transient atrioventricular block II degree. . All the symptoms are completely reversible Treatment: spend symptomatic and supportive treatment, no specific antidote is known.
Interaction with other drugs
There is no evidence that ondansetron induces or inhibits the metabolism of other drugs commonly prescribed in combination with it.
According to special studies found that ondansetron does not interact with ethanol, temazepam, furosemide, alfentanilom, tramadol, morphine, lidocaine, thiopental sodium and propofol .
Ondansetron is metabolized by several isozymes tsytohroma . Due to the variety of isoenzymes capable of metabolizing ondansetron, inhibition isoenzymes or decrease in the activity of one of the isoenzymes is typically compensated by other isoenzymes, whereby the total clearance of ondansetron or no change or only small and require little or no dose adjustment .
in patients taking potent inducers of the isoenzyme (phenytoin, carbamazepine, and rifampicin), ondansetron blood concentration may be reduced.
These special studies indicate that ondansetron may reduce the analgesic effect of tramadol.
the use of ondansetron in conjunction with drugs, prolong the interval of the , It may lead to an additional lengthening of the interval.
Simultaneous use of ondansetron parabolan with drugs having cardiotoxic properties (anthracyclines) may increase the risk of arrhythmias.
ondansetron at a concentration 16-160 mg / ml pharmaceutically compatible with the following drugs which may be administered via the Y-shaped injector:
– cisplatin (at a concentration of 0.48 mg / ml) for 1-8 hours;
– fluorouracil (at a concentration of 0.8 mg / ml at 20 ml / h – higher concentration may cause precipitation of ondansetron in the precipitate )
– carboplatin (in a concentration of 0,18-9,9 mg / ml for 10-60 min)
– etoposide (concentration 0,14-0,25 mg / ml for 30-60 min)
– ceftazidime (at a dose of 0.25-2.0 g as / in a bolus over 5 min)
– cyclophosphamide (at a dose of 0.1-1.0 g in the form of I / bolus injection for 5 m)
– doxorubicin (at a dose of 10-100 mg, in the form of I / bolus injection over 5 min)
– dexamethasone: possibly in / in a 20 mg dexamethasone slowly, within 2-5 min. Drugs may be administered via a drip, with parabolan a concentration of dexamethasone sodium phosphate solution may comprise from 32 .mu.g to 2.5 mg / ml, ondansetron – 8 mcg to 1 mg / ml.