Domperidone vs. Ondansetron

Ondansetron (brand name Zofran®) and domperidone are medications used to treat a variety of stomach complaints. Ondansetron is most commonly used to treat nausea. Though domperidone also can also be to treat nausea, it varies greatly in its side effects, intended uses and FDA approval.

Ondansetron

• The FDA-approved ondansetron, the generic form of Zofran®, in 2006. Ondansetron is available in 4 mg and 8 mg tablets as well as a 4 mg/2 ml injectable. It is also available in oral disintegrating tablets (ODT) form. It has been widely used in surgery patients and chemotherapy patients to prevent and treat nausea and vomiting. According to medicinenet.com, ondansetron blocks serontin, which is the hormone that can cause vomiting.

  Ondansetron does not increase stomach motility or peristalsis, whereas domperidone does.

Domperidone

• Domperidone is used to treat disorders of the stomach, such as gastroparesis, a condition in which the stomach does not contract (the action of peristalsis) to move food into the digestive tract. Though domperidone has been sent to the FDA for approval twice, the administration refuses to approve it for use in the Unites States because of studies proving it has serious risks. A warning letter from the FDA stated that it was aware of studies that showed intravenous administration of domperidone could cause cardiac arrhythmias, cardiac arrest and sudden death (DIOne). Though not approved, certain pharmacies in the United States and Canada will compound the medication for patients for use for gastroparesis.

Side Effects

• Ondansetron and domperidone also differ somewhat in their reported side effects. Domperidone has been known to cause headache, dizziness, dry mouth, nervousness, flushing, trouble sleeping, stomach cramps, hot flashes and leg cramps. Reported side effects for ondansetron include diarrhea or constipation, headache, lightheadedness or drowsiness--although not as common--as well as blurred vision.

Considerations

• When considering which medications to use to treat certain symptoms, the physician and patient always should weigh the risks versus benefits. The Food and Drug Administration, the United States safety defense against dangerous medications, clearly feels that domperidone should be used in a limited basis, or not at all. The benefits of using such a drug do not outweigh the risks of potential cardiac problems and sudden death. If a physician truly believes that a patient would benefit from domperidone, then it is his responsibility to educate the patient on the risks.

  In regards to its effect on treating nausea and vomiting, ondansetron should be used instead. It is the wiser, safer alternative.

Further Information

• For more information regarding the risks of domperidone, please visit the Food and Drug Administration website, fda.gov.