Ondansetron: reasons to be restrictive

Fatal anaphylactic reaction to intravenous infusion of Ondansetron: a report of two cases

“…In the report of Dermir et al, anaphylactic reaction to ondansetron occurred on the 56th dose albeit the patient received earlier doses without incidents [1]. Anaphylaxia also occurred after many administrations of ondansetron in the reports of Frigerio et al and Kossay et al [11,14].…”

“…The incidence of anaphylaxis to ondansetron is low and fatal evolution is exceptional [1,[10][11][12][13]. This has prompted some authors to suggest that ondansetron's use should be restricted in cases of anaphylaxia [14].…”

Delayed anaphylactic reaction to intravenous infusion of ondansetron report of 3 cases

“…Life-threatening reactions have been uncommonly reported [5] however, besides the mild side effects such as diarrhea (16%), fever (8%) headache (17%) [6], these drugs also have been reported to cause coronary vasospasm, [1,6], chest pain [7,8] generalized tonic-clonic seizures [4,9] dystonia [10] and allergic reactions that may be fatal [6,11]. This has prompted some authors to suggest that the drug's use should be restricted [12].…”

“…Thus, earlier doses have probably led to the sensitization of these patients. It was the 56 th dose of ondansetron in the case of Dermir et al that caused anaphylaxis albeit the patient received earlier doses with no adverse reaction [1] same situation on the case of Frigerio C et al [12] as wel as for Kossay and kwnk [16].…”

“…Some authors suggest that anaphylaxis may be class effect [10,11] while some others think it is drug specific effect [12] as ondansetron and tropisetron share indole heterocycle, while granisetron does not have indole ring [18].…”