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The following information outlines important safety precautions and warnings associated with the use of ondansetron (Zofran). It is crucial to read these details carefully and consult your healthcare provider if you have any concerns.

• Severe Allergic Reactions: Ondansetron (Zofran) may cause severe allergic reactions, which can be life-threatening. Symptoms include swelling of the face, hives, and anaphylaxis, which may manifest as dizziness, rapid heartbeat, choking sensation, difficulty breathing, or swelling around the eyes, lips, or tongue. Seek immediate medical attention if these symptoms occur.

• QT Prolongation (Abnormal Heart Rhythm): This medication can cause QT prolongation, a condition where the heart's rhythm becomes abnormal, potentially leading to life-threatening events. Those at increased risk include individuals with electrolyte imbalances, heart rhythm disorders, or those taking medications like amiodarone and ciprofloxacin. Regular heart monitoring, including electrocardiograms (EKGs), may be necessary. Contact emergency services if you experience chest pain, shortness of breath, or fainting.

• Serotonin Syndrome: Ondansetron (Zofran) can lead to serotonin syndrome, a potentially life-threatening condition resulting from excessive serotonin in the brain. The risk is higher when taken with other medications that increase serotonin levels such as certain antidepressants and migraine medications. Be vigilant for symptoms and consult your healthcare provider.

• Heart Attack Risk: There have been reports of heart attacks occurring shortly after taking ondansetron (Zofran), particularly with its injectable form. Symptoms of a heart attack include chest or arm pain, tightness, and shortness of breath. Seek emergency help immediately if these occur.

• Masking of Gut Blockage and Stomach Bloating: The medication may mask symptoms of gut blockage or bloating, especially in individuals who have recently undergone stomach surgery or are on chemotherapy. Notify your healthcare provider if you experience a lack of bowel movements or inability to pass gas.

• Phenylketonuria (PKU) Caution: The orally disintegrating tablets (ODTs) of ondansetron (Zofran) contain phenylalanine, which can be harmful to individuals with PKU. Discuss alternative formulations with your healthcare provider if you have this condition.

Contraindications:

• Do not use ondansetron (Zofran) if you are taking apomorphine (Apokyn) due to the risk of severely low blood pressure and potential loss of consciousness. Always consult your healthcare provider if you have any contraindications before using this medication.

When taking this medication, you might experience some common side effects which are generally mild. These include headaches, which occur in up to 24% of users, fatigue in up to 13%, constipation in up to 9%, and diarrhea in up to 6%. Other side effects like dizziness, anxiety, itchy skin, and rash have also been reported. While these are usually not severe, it's important to contact your healthcare provider if they persist or worsen.

There are also rare but serious side effects that require immediate medical attention. These include severe allergic reactions with symptoms such as hives, trouble breathing, and swelling of the face, lips, tongue, or throat. Abnormal heart rhythms, characterized by chest pain, irregular heartbeat, shortness of breath, or feeling faint, also need urgent assessment. Heart attacks, while very rare, are another serious concern.

Additionally, there's a risk of serotonin syndrome, a serious condition that can present with fast heart rate, dizziness, sweating, flushing, tremors, muscle stiffness or twitching, lack of coordination, distress, or hallucinations. If you notice any of these symptoms, seek medical help right away. Always remain vigilant about any changes in your condition and report new or worsening side effects to your healthcare provider.

When taking Ondansetron (Zofran), it's crucial to inform your healthcare provider of all medications and supplements you are using, whether prescribed, over-the-counter, or herbal. This medicine can interact with a variety of other drugs, potentially causing adverse effects.

Ondansetron should not be used with apomorphine due to a significant risk of low blood pressure and loss of consciousness. Additionally, there is a heightened risk of serotonin syndrome, a potentially serious condition, when Ondansetron is used alongside drugs that increase serotonin levels. These include certain antidepressants such as SSRIs (e.g., fluoxetine, paroxetine) and SNRIs (e.g., duloxetine, venlafaxine), as well as street drugs like MDMA ("ecstasy") and herbal supplements like St. John's wort. This risk is especially pronounced when starting or increasing the dosage of these medications.

Furthermore, Ondansetron may interact with a wide range of other medications, potentially requiring dose adjustments. It's important to consult with your healthcare provider to ensure safe use of Ondansetron, especially if you are on medications like tramadol, which can also increase serotonin levels, or cyclophosphamide, where there might be an increased risk of side effects. Always follow your healthcare provider's guidance on medication usage.