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Pediatric cases consistent with serotonin syndrome have been reported after inadvertent oral overdoses of ondansetronexceeding estimated ingestion of 5 mg per kgin young childrenReported symptoms included somnolenceagitationtachycardiatachypneahypertensionflushingmydriasisdiaphoresismyoclonic movementshorizontal nystagmushyperreflexiaand seizurePatients required supportive careincluding intubation in some caseswith complete recovery without sequelae within 1 to 2 days.
The development of serotonin syndrome has been reported with 5-HT 3 receptor antagonists aloneMost reports have been associated with concomitant use of serotonergic drugse.gselective serotonin reuptake inhibitorsSSRIsserotonin and norepinephrine reuptake inhibitorsSNRIsmonoamine oxidase inhibitorsmirtazapinefentanyllithiumtramadoland intravenous methylene blueSome of the reported cases were fatalSerotonin syndrome occurring with overdose of ZOFRAN alone has also been reportedThe majority of reports of serotonin syndrome related to 5-HT 3 receptor antagonist use occurred in a post-anesthesia care unit or an infusion center.
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in addition, postmarketing cases of torsade de pointes have been reported in patients using zofran.