Zofran and Alcohol – Is drinking while taking Ondansetron safe?

It can be argued that it is safe, at least to an extent, to drink alcoholic beverages such as wine or beer while taking the antiemetic drug Zofran (ondansetron). However, while it is technically “safe,” since no particuarly life-threatening interaction occurs, it is still not healthy, as Dr. Claudio Butticè, Pharm.D. suggests.

While this drug may interact with several other medications with potentially dangerous consequences, drinking alcohol while under treatment with it is not specifically contraindicated by its official prescribing information. In fact, it may be recommended in people struggling with alcohol use disorder (AUD). Nonetheless, this recommendation stems from the fact that when Zofran and alcohol are taken together, they might cause a broad range of negative side effects that supposedly prevent addicted patients from relapsing.

An Austin DWI lawyer says: “while there isn’t a direct life-threatening interaction, there are significant side effects that can arise from mixing the two. This is particularly relevant in DWI cases, where understanding the effects of substances on a person’s cognitive and motor functions is crucial.”

In a nutshell, whether their interaction is not exactly “dangerous”, it is not pleasant either, so a 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, which means that it is used to suppress or prevent nausea and vomiting. It is employed to help patients deal with the side effects of cancer treatments such as chemotherapy and radiotherapy, and to deal with the nausea experienced after general anesthesia and surgical interventions.

Ondansetron belongs to a family of medications called “sertrons” or “5-HT3 receptor antagonists.” They 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. Zofran comes both in injective and oral forms, including a fast-dissolving form to provide quick relief after chemotherapy treatment.

alcohol and drugs
Drinking during adolescence may have detrimental effects on mental and physical health. Source: iStock

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 within 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 ondansetron has no effects on alcohol pharmacokinetics, it may alter several elements of the physiological process that characterize alcohol intoxication, including physical sensations and mood. Zofran can increase the sedative effect of alcohol, and further augment some performance changes induced by the peculiar stimulant activity of drinking. Through a complex activity on the neuroendocrine system, it significantly augments the subjective sensation of intoxication caused by alcohol consumption. This feeling is so unpleasant, that most animals and humans treated with ondansetron often voluntarily renounce drinking.

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.

wine and grapes

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. Ondansetron and other prescription drugs such as baclofen can be used to help with addiction treatment since they may increase abstinence and withdrawal effects.

Although it has never been formally approved for this use, Zofran might be administered decrease alcohol consumption in early-onset alcoholics. There’s no final consensus on the dose that should be administered for this purpose, but it can be used in association with other drugs to improve its effectiveness in preventing AUD relapse. Ondansetron and naltrexone can be administered as combination therapy at a dosage of 4 µg/kg + 25 mg twice a day to improve drinking outcomes (reduced number of drinks per day and increased number of days without drinking).

The effectiveness of Zofran alone or in combination as a pharmacological treatment approach to alcoholism is increased when patients undergoing 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.

The Takeaway

Even if you are not struggling with AUD, you can receive a Zofran for several reasons, including off-label ones such as the treatment of nausea during pregnancy. Chances are you will not find any indication that ondansetron and alcohol may interact with each other, but as you can see, they do.

While their interaction will not pose any direct threat to your life, it may make you experience a broad range of particularly unpleasant symptoms, including dealing with a terrible hangover after some time. And even if you got Zofran recommended by your doctor to help you treat your alcohol addiction disorder, that’s just another reason to avoid drinking any alcoholic beverage.

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

REFERENCES

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  4. Bankole A. Johnson, et al. Pharmacogenetic Approach at the Serotonin Transporter Gene as a Method of Reducing the Severity of Alcohol Drinking. The American Journal of Psychiatry. Volume 168 Issue 3, March 2011, pp. 265-275.
  5. Johnson BA, Ait-Daoud N, Prihoda TJ. Combining ondansetron and naltrexone effectively treats biologically predisposed alcoholics: from hypotheses to preliminary clinical evidence. Alcohol Clin Exp Res. 2000;24(5):737–742. doi: 10.1111/j.1530-0277.2000.tb02048.x.
  6. 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
  7. Arias-Carrión O, Pöppel E (2007). “Dopamine, learning and reward-seeking behavior“.Act Neurobiol Exp 67 (4): 481–488.

Article updated on December 15, 2023