Last update: Oct. 4, 2020

Ondansetron

Very Low Risk for breastfeeding


Safe. Compatible.
Minimal risk for breastfeeding and infant.

Ondansetron is a 5-HT3 receptor antagonist with antiemetic activity.
It is used in the control and prevention of nausea and vomiting.
Administered intravenously, intramuscularly, orally or rectally in one or two doses per day.

Since the last update, we have not found published data on its excretion in breastmilk.

Its high volume of distribution and short half-life make it unlikely that it will be excreted in milk in significant quantities.

It is considered by experts to be safe and of choice in breastfeeding (Reece-Stremtan 2017, Rowe 2016) and probably compatible by prestigious medical associations (Mahadevan 2006).

Its use is safe in children between 1 and 24 months (Khalil 2005).

Furthermore, use after a cesarean does not affect a positive start to breastfeeing (Uerpairojkit 2016) or the health of the baby (Nallam 2017, Elkomy 2015), or the production of prolactin (Hale 2017 p729, Lissoni 1994).

Alternatives

Suggestions made at e-lactancia are done by APILAM´s pediatricians and pharmacists, and are based on updated scientific publications.
It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Ondansetron is also known as


Ondansetron in other languages or writings:

Group

Ondansetron belongs to this group or family:

Tradenames

Main tradenames from several countries containing Ondansetron in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 60 %
Molecular weight 293 daltons
Protein Binding 75 %
VD 2,2 l/Kg
Tmax 1,5 hours
T1/2 3 hours

References

  1. Hale TW, Rowe HE. Medications & Mothers' Milk. A Manual of Lactation Pharmacology. Springer Publishing Company. 2017
  2. Reece-Stremtan Sarah, Campos Matilde, Kokajko Lauren, and The Academy of Breastfeeding Medicine. Breastfeeding Medicine. ABM Clinical Protocol #15: Analgesia and Anesthesia for the Breastfeeding Mother, Revised 2017. Breastfeed Med. 2017 Nov;12(9):500-506. Full text (link to original source) Full text (in our servers)
  3. Nallam SR, Cherukuru K, Sateesh G. Efficacy of Intravenous Ondansetron for Prevention of Postspinal Shivering during Lower Segment Cesarean Section: A Double-Blinded Randomized Trial. Anesth Essays Res. 2017 Apr-Jun;11(2):508-513. Abstract
  4. Uerpairojkit K, Chesoh A, Budcharoentong D. Ondansetron for prophylaxis of spinal morphine induced nausea during early rooming in breastfeedinga randomized placebo controlled trial. J Med Assoc Thai. 2017;100:1283-9. Abstract Full text (link to original source) Full text (in our servers)
  5. Elkomy MH, Sultan P, Carvalho B, Peltz G, Wu M, Clavijo C, Galinkin JL, Drover DR. Ondansetron pharmacokinetics in pregnant women and neonates: towards a new treatment for neonatal abstinence syndrome. Clin Pharmacol Ther. 2015 Feb;97(2):167-76. Abstract
  6. Rowe H, Baker T, Hale TW. Maternal medication, drug use, and breastfeeding. Pediatr Clin North Am. 2013 Feb;60(1):275-94. Abstract
  7. Mahadevan U, Kane S. American gastroenterological association institute technical review on the use of gastrointestinal medications in pregnancy. Gastroenterology. 2006 Jul;131(1):283-311. Review. Abstract Full text (link to original source) Full text (in our servers)
  8. Khalil SN, Roth AG, Cohen IT, Simhi E, Ansermino JM, Bolos ME, Coté CJ, Hannallah RS, Davis PJ, Brooks PB, Russo MW, Anschuetz GC, Blackburn LM. A double-blind comparison of intravenous ondansetron and placebo for preventing postoperative emesis in 1- to 24-month-old pediatric patients after surgery under general anesthesia. Anesth Analg. 2005 Aug;101(2):356-61, table of contents. Abstract
  9. Roila F, Del Favero A. Ondansetron clinical pharmacokinetics. Clin Pharmacokinet. 1995 Abstract
  10. Lissoni P, Cazzaniga M, Rovelli F, Mainini E, Tancini G, Barni S. Ondansetron does not stimulate prolactin release in breast cancer patients. Tumori. 1994 Abstract

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