Ondansetron

Ondansetron was approved in January 1991 for prevention of nausea and vomiting from highly emetogenic chemotherapy including cisplatin, with moderately emetogenic chemotherapy, radiotherapy (total body irradiation and abdominal fields) and post-operative nausea added later, and oral, orally disintegrating, film and injectable forms available. Its introduction, the first selective 5-HT3 antagonist, transformed supportive care and it remains the backbone of antiemetic prophylaxis worldwide and on the WHO essential medicines list. QT prolongation led the FDA to withdraw the 32 mg single intravenous dose in 2012; headache and constipation are common and serotonin syndrome is a rare interaction. Palonosetron and granisetron are the longer-acting alternatives.