Zofran vs. Compazine for Nausea: Important Differences and Potential Risks.

Key takeaways

Ondansetron (Zofran) and prochlorperazine (Compazine) are both used to treat nausea and vomiting, but they have some key differences. Ondansetron is an antiemetic that works by blocking serotonin in the brain, while prochlorperazine is a phenothiazine that blocks dopamine. Ondansetron is available in various forms, including tablets, dissolvable tablets, oral solution, and injections, and is typically taken every 8 to 12 hours. Prochlorperazine, on the other hand, is usually taken 3 to 4 times daily and is also used to treat schizophrenia and generalized anxiety disorder. Ondansetron is considered safer during pregnancy, although it is not FDA-approved for this use, whereas prochlorperazine is not recommended during pregnancy due to potential risks to the baby. Prochlorperazine can cause serious side effects like uncontrolled muscle movements and extreme sleepiness, making it less favorable for long-term use. Both medications are available in generic forms, making them more affordable options.

Ondansetron

(Zofran)

Get free coupons

Prochlorperazine

Get free coupons

Summary for Zofran

Prescription only

Ondansetron (Zofran) is an antiemetic (or anti-nausea) medication. It's used to prevent nausea and vomiting after surgery or cancer treatments. It works by stopping a chemical called serotonin from binding to receptors in the brain that cause the feeling of nausea and vomiting. Ondansetron (Zofran) is taken by mouth, typically every 8 to 12 hours. It comes in different formulations, including orally disintegrating tablet (ODT) and oral solution. It can also be given as injection by a healthcare professional (HCP) in a hospital setting. Side effects of this medication include headache, tiredness, and constipation or diarrhea.

Indications for Zofran

Prevention of nausea and vomiting due to cancer medications (chemotherapy) or radiation therapy
Prevention of nausea and vomiting after surgery

Pros and Cons for Zofran

Pros

Can use for both adults and children
Available as a lower-cost generic
Available as a liquid, dissolvable tablet, and injection for people who have problems swallowing pills or are too nauseous to keep medication down
Possible option during pregnancy and breastfeeding

Cons

Needs to be taken multiple times daily
Might cause headache
Can interact with certain medications, like antidepressants and migraine medications
Not the best option for people who are at risk for stomach or gut blockages (bowel problems)

Common Side Effects for Zofran

Headache (up to 24%)
Fatigue (up to 13%)
Constipation (up to 9%)
Diarrhea (up to 6%)

Warnings for Zofran

Severe allergic reactions
Life-threatening abnormal heart rhythm (QT prolongation)
Serotonin syndrome
Risk of heart attack
Masking of gut blockage and stomach bloating
Caution use in people with phenylketonuria (PKU) - orally disintegrating tablets only

Summary for Compazine

Prescription only

Prochlorperazine is used to treat severe nausea and vomiting. It's also used to improve mood, thoughts, and behaviors for people with schizophrenia and anxiety. It's not a first-choice medication because it can cause serious side effects, such as extreme sleepiness, falls, and uncontrolled muscle movements. Prochlorperazine comes as a tablet that's taken by mouth, typically 3 to 4 times daily. The brand name version of prochlorperazine (Compazine) is no longer available.

Indications for Compazine

Severe nausea and vomiting
Schizophrenia
Generalized anxiety disorder (GAD)

Pros and Cons for Compazine

Pros

Available as a generic medication
Available as an oral tablet or suppository for treating nausea and vomiting
Typically starts working in 30 minutes and effects last up to 4 hours

Cons

Many serious and sometimes possibly permanent side effects, such as uncontrolled muscle movements
Can't be used in children under 2 years old or under 20 pounds due to higher risk of serious side effects
Not recommended for use in pregnancy or during breastfeeding

Common Side Effects for Compazine

Drowsiness
Dizziness
Absent menstrual periods
Blurry vision
Low blood pressure

Warnings for Compazine

Higher risk of death in older adults with dementia-related psychosis
Difficulty controlling muscle movements (tardive dyskinesia)
Other conditions with uncontrolled muscle movements (dystonia, Parkinsonian symptoms, and restlessness)
Neuroleptic malignant syndrome (NMS)
Cover up more serious health problems
Higher risk of infections
Higher risk of falls
Liver problems
Seizures
High prolactin levels
Difficulty maintaining normal body temperature