Anaphylactoid-Anaphylactic Reactions Associated with Ondansetron

Fatal anaphylactic reaction to intravenous infusion of Ondansetron: a report of two cases

“…Life-threatening adverse reactions have been uncommonly reported, and may be secondary to coronary vasospasm, hypotension and generalized tonic-clonic seizures [3,4,9]. The incidence of anaphylaxis to ondansetron is low and fatal evolution is exceptional [1,[10][11][12][13]. This has prompted some authors to suggest that ondansetron's use should be restricted in cases of anaphylaxia [14].…”

Hypersensitivity to Intravenous Ondansetron

“…In this case the reaction could be either anaphylaxis or Anaphylactoid, but latter seems more likely given the history of absence of prior sensitization [6,7]. Other components of the drug, such as solvent, also need to be considered as a cause of the reaction.…”

“…Hypersensitivity reactions characterized by rashes, swelling, shortness of breath and cardiopulmonary arrest have been reported in patients who have exhibited hypersensitivity to other selective 5-HT3 receptor antagonists. However, some authors suggest that the anaphylaxis may be a class effect while others think it may be drug specific [6].…”

Delayed anaphylactic reaction to intravenous infusion of ondansetron report of 3 cases

“…ondansetron those prescribing it or other 5HT3 antagonists should exercise extreme caution especially in patients with history of hypersensitivity reactions We also caution against off label use of these drugs, especially in out of hospital set up [18]. Otherwise the precise mechanism of the adverse reaction to ondonsetron is unclear, but negative skin prick test does not support or nullify IgE mediated mechanism or histamine liberation by mastocytes [13,19]. Treatment was based on chemotherapy regimen containing cytarabine arbinosde and anthracyclins which is usually associated with ondansetron to prevent chemo-induced vomiting.…”

“…The precise mechanism of the adverse reaction to ondansetron is unclear. Chen et al analysed results from the US Federal Drug Administration spontaneous reporting system with respect to ondansetron and were able to find 24 reports describing anaphylactic-anaphylactoid reaction [13].…”