Why is Zofran prescribed to children with nausea

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If your child has recently been to the emergency room due to vomiting and dehydration , they may have been given a dose of zofran (ondansetron). You may wonder why this drug, which is used for nausea in cancer chemotherapy , is used in children with the stomach flu . It has become very common in emergency departments for acute gastroenteritis (stomach flu).

Get Drug Information / Nusha Ashjai

Using Zofran for stomach flu

Although Zofran is only approved to prevent nausea and vomiting in patients undergoing chemotherapy or surgery, many drugs are dispensed for other conditions. In this case, there are many studies that show that Zofran may be beneficial for the treatment and prevention of vomiting associated with acute gastroenteritis.

A 2011 Cochrane review of studies found that oral ondansetron helped children and adolescents stop vomiting and reduced the need for IV rehydration and hospitalization.

When Zofran is given to children

Although many doctors find Zofran helpful in the emergency department for the prevention and treatment of vomiting in gastroenteritis, your pediatrician may not prescribe it on an outpatient basis. Current practice guidelines, including those from the American Academy of Pediatrics, do not recommend the use of medications to stop vomiting.

There is no research showing it to work in this situation as all research was done in an emergency room setting. If more research confirms this, doctors may be using it more to treat children with stomach flu.

Warnings for Fenergan and Zofran

Phenergan (promethazine) is often used to control nausea and vomiting, but in 2006 the FDA recommended against using it in children younger than 2 years old. This medicine carries the risk of slowing or stopping breathing in infants and young children.

In older children, Phenergan falls asleep so often that many pediatricians do not like to use it. Even if your child is not vomiting, if he is too sleepy to drink when he has a stomach virus, he is probably still dehydrated.

However, Zofran has a caveat of its own, at least for the highest doses that were ever intended for nausea and vomiting associated with chemotherapy. This follows a study that showed that a single 32-milligram dose can affect heart rate, leading to a prolonged QT interval.

This dosage, however, is no longer available and far exceeds the 2-8 milligrams commonly prescribed for children and adolescents.

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