Podcast # 470: Zofran and Pregnancy

Author: Jared Scott, MD

Educational Pearls:

• Ondansetron (Zofran) is one of the latest drugs that has had concerns raised about side effects, particularly in pregnancy
• 2018 study probed two birth defect databases to assess increases in 51 major birth defects with increased exposure to ondansetron
• Only two of the 51 had even a modest increase, which is unclear in causation (cleft palate and renal agenesis)
• When administering ondansetron (or any drug) to pregnant women, be able to discuss any potential risks for an informed decision by the patient

Editor's note: in this study, adjusted odds ratios for risk of birth defects from exposure to ondansetron were: cleft palate 1.6 (95% CI 1.1-2.3) and renal agenesis 1.8 (95% CI 1.1-3.0)

References

Parker SE, Van Bennekom C, Anderka M, Mitchell AA. Ondansetron for Treatment of Nausea and Vomiting of Pregnancy and the Risk of Specific Birth Defects. Obstet Gynecol. 2018 Aug;132(2):385-394. doi: 10.1097/AOG.0000000000002679. PubMed PMID: 29995744.

Summarized by Will Dewispelaere, MS3 | Edited by Erik Verzemnieks, MD