Any dangerous Ondansetron drug interactions?

[Hilopsilo]

So just after reading about ondansetron, the magical prescription anti-emetic, I was cleaning my apartment to move out and found a bottle of the stuff!

Judging my the date and doctor who prescribed it, its from when I got my wisdom teeth out ~2 years ago. Was probably meant to go with the vicodin, but I never ended up needing it.

Anyways, this stuff seems to be really useful and sought after. As someone with the worlds weakest stomach, this is extra useful for me!

My drugs use is only psychedelic drugs, including MDMA. Are there ANY dangerous drug interactions between ondansetron and any psychedelic drugs? Is there anything I should know about ondansetron before using it in combination with any drugs recreationally? I figure its gotta be prescription and not OTC for some reason. Any info/advice would be much appreciated!

 

[Doclad]

Ondansetron is a very effective antiemetic because of its antagonism of Serotonin 5-HT3 receptors, oral 4mg are enough to antagonize them.
As far as I know, there is no problematic interaction if it is taken together with a psychedelic or MDMA, but I am no expert on this subject.

If you want to learn a little about this wonderful drug go to Wikipedia and take a look. https://en.wikipedia.org/wiki/Ondansetron

Perhaps in the sub-forum of Pharmacology I would find more elaborate answers.


DocLad

 

[Hodor]

Ondansetron is basically a wonder drug as far as vomiting is concerned.

The reason it remains prescription-only is presumably its potential for causing cardiac arrythmias when used in *very* high doses in susceptible individuals, but this risk applies to a lot of drugs (including various antidepressants and basically any antipsychotic).

It certainly is a far safer option than metoclopramide.

That said, I wouldn't immediately go "heroic dose" with this combo. It is still not entirely impossible that 5HT3 antagonism may result in some sort of potentiation of other psychedelic effects that would normally be kept in check by 5HT3.

 

[Limpet_Chicken]

It is also EXTREMELY overpriced to the medical infrastructure, so it is often reserved for very emetogenic types of chemotherapy.

I have a script myself, for some stomach problems and it really works wonders. Stopped me barfing up bile after a hangover from hades yesterday for example.

 

[Limpet_Chicken]

I've taken it, with 1p-LSD, and with alpha-methyltryptamine (racemic afaik) due to its being somewhat of a gutbuster. 5HT3 is primarily expressed in the gut, AFAIK, and in any case, no negative interactions noted at any doses of either taken.

 

[mr peabody]

Some reports I found:

You should not take Zofran if you take a drug called apomorphine, which is an injectable drug used to treat Parkinson’s disease. The combination of apomorphine and ondansetron can cause dangerously low blood pressure.

You also should not use Zofran if you've had an allergic reaction to a different serotonin 5-HT3 receptor antagonist. Brand names of these include Lotronex, Anzemet, Kytril, and Aloxi.

Drugs that are known to interact with Zofran and may cause problems include:

- Apomorphine
- Other serotonin 5-HT3 antagonists, including Lotronex, Anzemet, Kytril, and Aloxi
- Some antibiotics, such as clarithromycin (Biaxin, in Prevpac) and erythromycin (E.E.S., Erythrocin)
- Medications to treat irregular heartbeat, such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn) and others
- Beta blockers, or drugs used to slow the heart rate, such as acebutolol (Sectral), atenolol (Tenormin), bisoprolol (Zebeta) and others
- The pain medicine tramadol (Ultram, in Ultracet)
- Some antiseizure medications, such as phenytoin (Dilantin)
- Some antipsychotic medications, including thioridazine (Mellaril), haloperidol (Haldol), and mesoridazine (Serentil)
- Some drugs used to treat depression, including venlafaxine (Effexor) and amitriptyline (Elavil)

https://www.everydayhealth.com/drugs/ondansetron

More information here:

https://www.drugs.com/drug-interactions/ondansetron,zofran-index.html?filter=3&generic_only=

https://www.rxlist.com/drug-interactions/contraindicated-index/ondansetron-hcl-oral.htm

 

[Limpet_Chicken]

Apo-morphine is not going to be used recreationally though, its a potent, rapid, sure emetic and even in the 1700s they were using it as such, as one of the newest meds with good safety they had at around 1890 or so too)

Confusion with morphine, would be most unpleasant. Back in the day, it was made from morphine, and likely still is, by heating morphia with hydrochloric acid in a sealed glass tube. This reaction affords apomorphine from morphine directly.

Is this a generic interaction thats common to DA agonists on the whole? Because I take a dopamine agonist, pramipexole, and I've never noticed any problems with the two, indeed when getting used to pramipexole, and it began to be nauseating due to speed of titration, I used ondansetron alongside cyclizine to circumvent it and allow the dose to be adjusted faster to find the endpoint dose more rapidly and without problem.

 

[JackARoe]

Apo-morphine is not going to be used recreationally though, its a potent, rapid, sure emetic and even in the 1700s they were using it as such, as one of the newest meds with good safety they had at around 1890 or so too

William S Burroughs was raving about Apo-morphine in Naked Lunch and Junkie as a treatment for opiate addiction. He talked about it like it got rid of a lot of symptoms of withdrawal. I have never heard that again though.

I didn't know ondansetron was that potent and worked as well as it does. Anti emetics are usually hit or miss.

 

[Limpet_Chicken]

I got shot up with ondansetron once, in the ER, after ending up vomiting blood-streaked bile and stuff that felt like some sort of internal organ I didn't even know I had just went tap dancing in a bath tub full of acetone peroxide.

I find pramipexole not unpleasant on opioids, added to a shot etc.

 

[bindingaffinity]

Drugs that are known to interact with Zofran and may cause problems include:

- The pain medicine tramadol (Ultram, in Ultracet)
- Some drugs used to treat depression, including venlafaxine (Effexor) and amitriptyline (Elavil)

For the record, although this is stated on the US package inserts for ondansetron, I couldn't find any case reports in the literature of ondansetron causing serotonin syndrome (other than this one which has like 4 other drugs involved, including two different SSRIs and a CYP2D6 inhibitor, which may have been the problem), and it's been actively studied as an adjunct to SSRIs in OCD patients, where the combination has been described as "very well-tolerated".

 

[Volsam]

Yeah, the only problem I encounter with Ondansetron is price... A must have tool for Mescaline and Ayahuasca/Pharmahuasca. Also when quitting weed abruptly and having hyperemesis syndrome in the morning.