Zofran and Alcohol – Is drinking while taking Ondansetron safe?

Is it safe to drink alcoholic beverages such as wine or beer while taking the antiemetic drug Zofran? Although ondansetron may interact with several other medications with dangerously negative consequences, drinking alcohol while under treatment with it is not specifically contraindicated by its official prescribing information. Nonetheless, the answer to the question is probably much more complicated than one may expect.

What is Zofran and what it is used for?

Zofran is the commercial name of ondansetron, an antiemetic medication manufactured by GlaxoSmithKline (GSK) and approved by the Food and Drugs Administration (FDA) in 1991. It is an antiemetic medication used to suppress or prevent nausea and vomiting consequent to cancer treatments such as chemotherapy and radiotherapy, and surgical interventions. Ondansetron belongs to a family of medications called “sertrons” or “5-HT3 receptor antagonists” that work by preventing the binding of a neurotransmitter called serotonin to its brain receptor called 5-HT3. This brain receptor is responsible for the vomit stimulus, so blocking it will prevent nausea and vomit. It comes both in injective and oral forms, including a fast-dissolving form to provide quick relief.

Why it is dangerous to drink alcohol while taking Zofran?

As explained before Zofran is a 5-HT3 receptor antagonist that inhibits the action of the chemical messenger serotonin in the brain. However, because of its specific mechanism of action, it has shown to be effective in changing how the human brain reacts to the effects of alcohol. Although it has no effects on alcohol pharmacokinetics, ondansetron may alter several elements that characterize alcohol intoxication, including physical sensations and mood. Zofran can thus increase the sedative effect of alcohol, and further augment some performance changes induced by the peculiar stimulant activity of drinking. This drug significantly augments the subjective sensation of intoxication caused by alcohol consumption, to the point that animals and humans treated with this drug often voluntarily renounce drinking.

Zofran and alcoholism – a potential new treatment

The effects of ondansetron on alcohol consumption have been extensively researched in the last two decades. This drug has been, in fact, found to be helpful in stopping cravings, reducing the urge to consume alcohol in alcohol-dependent individuals. Zofran can be used to treat addiction as it may increase abstinence and decrease alcohol consumption in early-onset alcoholics. Its effectiveness as a pharmacological treatment approach to alcoholism is increased when patients undergo cognitive-behavioral therapy (CBT) to increase their abstinence. Researchers also suggested that this drug may show an even higher reduction in severe drinking in some groups of genetically predisposed individuals.

Ondansetron own mechanism of action as a serotonin inhibitor seems to be the one responsible for these behavioral changes in alcohol consumption. Alcohol craving is in fact believed to be caused by an imbalance between the two neurotransmitters dopamine and serotonin. Zofran blocks the serotonin receptor which, in turn, decreases the release of dopamine induced by alcohol consumption. Dopamine is believed to be the principal neurotransmitter involved in the pleasure-reward system: blocking it effectively diminishes the ability to experience pleasure after drinking alcohol.

Article written by: Dr. Claudio Butticè, Pharm.D.

REFERENCES

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5. Bankole A. Johnson, et al. Determination of Genotype Combinations That Can Predict the Outcome of the Treatment of Alcohol Dependence Using the 5-HT3 Antagonist Ondansetron. The American Journal of Psychiatry. Volume 170 Issue 9, September 2013, pp. 1020-1031
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Article updated on September 16, 2022