Zofran generic: Availability, cost, and more

In this article:

• Why was Zofran discontinued?
• What are the differences between brand-name and generic Zofran?
• Zofran (ondansetron) warnings and side effects
• How much does ondansetron cost without insurance?
• What are the off-label uses for ondansetron?

In this article

• Why was Zofran discontinued?
• What are the differences between brand-name and generic Zofran?
• Zofran (ondansetron) warnings and side effects
• How much does ondansetron cost without insurance?
• What are the off-label uses for ondansetron?

Zofran (ondansetron) is a prescription antiemetic medication used to treat and prevent nausea and vomiting in people undergoing treatment for cancer, as well as postoperative nausea and vomiting. It works by blocking the release of the brain chemical serotonin, which can suppress nausea and lessen the urge to vomit. Zofran was approved in 1991 by the Food and Drug Administration, but was eventually discontinued as a brand-name drug. However, it’s still available in generic form as ondansetron. Here’s what to know about taking this common anti-nausea and vomiting medication.

Why was Zofran discontinued? 

Various forms of Zofran have been discontinued over the years for different reasons. In 2012, high intravenous (IV) doses of the drug were taken off the market because they posed a cardiac risk, potentially causing an irregular heart rhythm called QT interval prolongation. By 2023, all other forms of brand-name Zofran were discontinued, but not for safety or efficacy reasons. The dissolvable tablets were discontinued because the packaging didn’t meet federal regulations for safety (the tablets themselves were safe), and other forms of the drug were no longer profitable once generic versions became widely available.

What are the differences between brand-name and generic Zofran?

Brand-name drugs and generic drugs are largely the same. They contain identical active ingredients and have the same safety and effectiveness. “When brand-name Zofran was still on the market, there were no meaningful differences between it and ondansetron,” says Erika Gray, Pharm.D., cofounder of Toolbox Genomics. 

“Generic ondansetron is held to strict FDA standards for bioequivalence, ensuring it delivers the same therapeutic effect as the original brand,” she explains. “While some patients may have perceived differences based on pill appearance, taste, or tolerability, especially with orally disintegrating tablets, these variations are due to inactive ingredients rather than any change in efficacy and safety.”

Zofran (ondansetron) warnings and side effects
	Zofran (ondansetron)
Uses	Treatment and prevention of nausea and vomiting due to: Chemotherapy Radiation therapy Post-surgery
Standard dosage	Adults: 4 to 24 mg Children 4 to 11: 4 mg Children 12 to 17: 8 mg
Common side effects	Headache, constipation, fatigue, dry mouth, dizziness
Contraindications	Do not take if you are allergic to ondansetron Do not take if you are using apomorphine (Apokyn) to treat Parkinson’s disease Use caution if you have phenylketonuria or liver disease Use caution with other drugs that affect serotonin levels or are known to cause QT interval syndromes
Other considerations	Some patients are at risk of experiencing dangerous interruptions to normal heart rhythm when using Zofran, per Dr. Gray (QT interval prolongation). If you have any history of cardiac disease or arrhythmia, be sure to discuss these risks with your healthcare provider.

How much does ondansetron cost without insurance?

Without insurance, ondansetron costs about $151 for 10, 4 mg disintegrating tablets. Using a SingleCare discount card, your cost could be lowered to $5 for 10, 4 milligram disintegrating tablets.

What are the off-label uses for ondansetron? 

Ondansetron can help ease nausea and vomiting in people going through cancer treatment, since these are common side effects of chemotherapy and radiation therapy. It can also be given right after surgery to relieve post-operative nausea and vomiting associated with anesthesia use. Ondansetron has a few other off-label uses, too.

Morning sickness

According to Katina Hope, MD, a family medicine physician with Village Medical, ondansetron is sometimes used to treat morning sickness during pregnancy, though it hasn’t been approved by the FDA for this purpose.

Some studies suggest there is a higher risk of certain birth defects associated with taking ondansetron during the first trimester, but the risk appears to be low. In general, ondansetron is considered a relatively safe way to manage morning sickness, especially if other strategies (like B6 supplementation) don’t help and your morning sickness is affecting your quality of life.

Gastroparesis

Dr. Gray says ondansetron can be used to treat gastroparesis-related nausea in people who don’t respond to first-line treatments like metoclopramide. Gastroparesis, also called delayed gastric emptying, is a condition where your stomach stops moving food into your intestines or only moves it very slowly. Nausea and vomiting are two of the most common symptoms of gastroparesis.

Other 

There are many conditions that cause nausea and vomiting, and Dr. Gray says ondansetron may be prescribed to help relieve those symptoms, either as a first-line treatment or when other more common treatments fail to work.

Some of these conditions include:

• Cyclic vomiting syndrome
• Vertigo
• Acute gastroenteritis (i.e., a stomach bug)
• Acute mountain sickness

Bottom line

Zofran (ondansetron) is a generic prescription drug that relieves nausea and vomiting. It’s prescribed for the treatment of these symptoms during cancer treatment and after surgery, but is also frequently prescribed for other conditions that cause nausea and vomiting, including pregnancy, gastroparesis, vertigo, and other gastrointestinal conditions. Brand-name Zofran was fully discontinued in 2023, but generic ondansetron is still available. In general, ondansetron is safe for most people to take, but it has the potential to dangerously disrupt normal heart rhythm and interfere with other medications, including those that affect serotonin levels.