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Which One is Better in Pregnancy, Ondansetron or Palonosetron?

Everyone is asking the same questions, which one better ondansetron or palonosetron? Go there are lots of debates; we will discuss today the difference between palonosetron vs. ondansetron considering only the Pregnancy case.

A recent study shows ondansetron is linked to congenital disabilities. Nausea and vomiting of pregnancy occur in up to 80% of pregnant women. Ondansetron used during pregnancy for morning sickness, or nausea has a link to severe congenital disabilities.

Palonosetron Vs Ondansetron

Danish study detected the following complications are linked to Ondansetron.

  1. Cleft palate
  2. Septal defect
  3. Cardiac defect
  4. Fetal malformations

Ondansetron Congenital Birth Defects

To ensure the safety of mothers and to prevent congenital birth defects we should use palonosetron. Palonosetron has some benefits over ondansetron. Palonosetron acts faster and lasts longer.

Palonosetron does not cause significant adverse effects like a congenital birth defect in pregnant mothers. No clinical data supports that palonosetron could increase the risk of congenital heart defects including- heart defects, cleft lip and cleft palate.

After considering this Danish study, we should have an idea to avoid ondansetron in pregnancy and choose palonosetron. There is lot controversy using ondansetron and palonosetron, but still, there is no alternative drug to prevent chemotherapy-induced nausea and vomiting.

In case of postoperative nausea and vomiting, there is a research article comparing ondansetron versus palonosetron. In that study, palonosetron is also superior to ondansetron controlling postoperative nausea and vomiting. Overall patient satisfaction and adverse effect profile are favorable for palonosetron than ondansetron. I am attaching the article of PDF link here.

About Dr. Toufiq Hassan

I am Dr. Toufiq Hassan Shawon, currently working as a medical officer at Trisal Upazilla Health Complex, Mymensingh. I have passed MBBS from Rajshahi Medical College in 2013 January, Batch - 49. My school was B.A.F. Shaheen College, Tejgaon, Dhaka, SSC-2005 and College was Notre Dame College, HSC-2007.

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