Can you get generic Zofran over the counter?

In this article:

• Can you get generic Zofran over the counter?
• Generic Zofran OTC substitutes
• Prescription ondansetron alternatives

In this article

• Can you get generic Zofran over the counter?
• Generic Zofran OTC substitutes
• Prescription ondansetron alternatives

Brand-name Zofran has been discontinued, but generic ondansetron is still regularly prescribed to relieve nausea and vomiting from cancer treatments and recent surgery. It’s often prescribed off-label to treat nausea from other causes, like morning sickness from pregnancy. 

Whether from food poisoning, migraine headaches, or taking medication on an empty stomach, it’s common to deal with nausea from time to time. Unfortunately, Zofran isn’t available over-the-counter, so you’d need to visit a healthcare provider to obtain this option for nausea relief.

While Zofran is available over the counter in many other countries, that’s not the case in the United States. However, that doesn’t mean you’re out of options. There are over-the-counter choices that address nausea and don’t require a prescription or visit to a doctor or pharmacist. 

Check out what the medical experts had to say about the best over-the-counter (OTC) alternatives for Zofran below.

Can you get generic Zofran over the counter?

“Zofran (ondansetron) is not available over the counter in the U.S. because it’s a serotonin 5-HT3 receptor antagonist,” said Dr. Kisha Pickford, an acute care nurse practitioner at Ample Health and Wellness. “Improper use could mask serious conditions or cause complications in people with certain medical histories.”

Along with masking conditions, Zofran also comes with a risk of serious side effects, like serotonin syndrome or a severe allergic reaction, although these are fairly rare.

Luckily, you don’t have to go without anti-nausea treatment if you don’t have a Zofran prescription. Several over-the-counter medicines are available that can help with various types of nausea.

Generic Zofran OTC substitutes

“While they’re not as potent as Zofran, there are a few OTC remedies that can help with mild to moderate nausea,” said Dr. Uma Darji, MD, a family medicine practitioner in North Carolina.

The best over-the-counter treatment will vary depending on the cause of your nausea symptoms. While there is no over-the-counter equivalent to Zofran, there are still plenty of good options.

“As always, before starting something new, even if it is over the counter, check with your doctor to ensure it doesn’t interact with other medications and is safe for your medical conditions,” advised Dr. Darji. You can also visit the pharmacy for medical help, where they can explain possible drug interactions and the active ingredients in the alternative products you want to try.

According to medical experts, here are the top over-the-counter substitutes for Zofran. 

Meclizine

Meclizine, also sold under the brand names Bonine and Antivert, is an antihistamine (H1 receptor antagonist) that can help control and prevent nausea and vomiting from motion sickness. Studies have found it provides effective relief for motion-sickness-evoked nausea because it has an inhibitory effect on eye movement reflexes, which can improve motion sensitivity.

Dramamine

Nausea strikes at unexpected moments, but for those who commonly experience motion sickness, there is a powerful medication that can help: Dramamine. This medication is a must-have travel essential when flying or going on a road trip..

Dramamine (dimenhydrinate) treats motion-related nausea and may also be a good substitute for Zofran. As a first-generation antihistamine, it also has sedative side effects. One study found that a single dose of dimenhydrinate caused ‘significantly impaired decision reaction time,’ so it may not be a good option for those who need to stay sharp or those that drive for a living.

Pepto Bismol

Bismuth subsalicylate, sold under the well-known brand name Pepto-Bismol, is a pink-colored medication that comes in liquid or chewable tablet form. It treats nausea related to indigestion or upset stomach by lining the GI tract, or digestive system, with a protective coating.

Available for nearly 100 years, this over-the-counter treatment has been a go-to nausea treatment for decades. In the 1980s, researchers found that for indigestion, ‘relief was achieved faster and in a higher proportion of cases’ for participants taking bismuth subsalicylate compared to a placebo.

Ginger supplements

There are various ginger-containing products on the market to help treat nausea, including ginger supplements, ginger chews, and ginger lozenges. In 2024, an overview of systematic reviews and meta-analyses found that ginger can be effective for various types of nausea. The results indicated that ginger was effective in managing chemotherapy-induced nausea and vomiting, reducing postoperative nausea and vomiting, as well as alleviating pregnancy-related nausea and vomiting.

Other herbal products, like peppermint, may also provide nausea relief.

Prescription ondansetron alternatives

“If Zofran isn’t an option or isn’t effective, there are other medications that can be used depending on the cause of the nausea,” said Dr. Darji.

Since these are not over-the-counter, these anti-nausea medications will require a doctor’s prescription. In general, common prescription Zofran alternatives that help treat nausea include:

• Phenergan (promethazine): A sedating antihistamine often used in emergency and surgical settings for nausea and vomiting.
• Compazine (prochlorperazine): A dopamine-blocking medication used for moderate to severe nausea or migraine-related nausea.
• Reglan (metoclopramide):  A medication that helps treat nausea tied to slow gastric emptying or reflux.
• Scopolamine patches: A patch commonly used for motion sickness, post-operative, or surgery-related nausea.

Dr. Darji added, “Each has its own side effect profile and best-use scenario, so the choice depends on the patient’s underlying conditions and medical history.”