Ondansetron Usage in HIV Positive Patients: A Pilot Study on the Control of Nausea and Vomiting in Patients on High Dose Co-Trimoxazole for Pneumocystis Carinii Pneumonia

Abstract

This was an open, single centre study, to evaluate the safety and efficacy of ondansetron in the treatment of co-trimoxazole associated nausea and vomiting in AIDS patients. Sixteen patients presenting with their first episode of HIV-associated Pneumocystis carinii pneumonia (PCP) on high dose co-trimoxazole were given ondansetron 8 mg orally, every 8 h. Measurements were made from data recorded by each patient on diary cards. In this study 11 out of 16 (69%) patients on ondansetron experienced good control of emesis (2 or less emetic episodes) on their 'worst day' of therapy and 8 out of 16 (50%) of patients demonstrated good control of emesis throughout their treatment with co-trimoxazole. Good control of nausea (mild or none) was achieved in 7 out of 16 (47%) patients. A total of 7 patients were able to complete the full course of co-trimoxazole whilst on ondansetron. One serious adverse event (Stevens-Johnson syndrome) was reported and felt to be unrelated to ondansetron. If conventional anti-emetics fail to achieve control of symptoms or have unacceptable side effects, ondansetron may represent a possible alternative.

Nausea and vomiting in HIV: a symptom review

“…A small-scale study evaluating the efficacy of zofran for patients on high-dose bactrim for Pneumocystis carinii pneumonia (PCP) was conducted by Gompels et al in 1993. 29 The results indicated that 50% (8 of 16) experienced less vomiting during PCP treatment with zofran. While GI symptoms including nausea and vomiting have been found at levels similar to those reported for cancer patients, 30 management could prove to be quite different.…”