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Ondansetron and cardiac arrhythmias


Ondansetron used to be the preserve of the Oncologists for children struggling with chemotherapy-induced nausea. Recently, however, its use for the symptomatic relief of nausea and vomiting in the Emergency Department has significantly increased.

Less vomiting = less chance of dehydration and need for admission for fluids. All good? Well, not quite.

In 2011 in the USA the Food and Drug Administration (FDA) issued a warning that Ondansetron administration was associated with fatal arrhythmias. So, should we stop using ondansetron? What’s the actual risk of arrhythmia?

Freedman et al looked at this dilemma in this paper form the Annals of Emergency Medicine which can be found here.

And I have summarised in the infographic below:


  • Ian is a Paediatric Emergency Medicine Consultant based in Derby. He loves #FOAMed, Apple products, Comics, running and his family. In that order. He dislikes cauliflower cheese.


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