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6 Interactions found for:

ondansetron and MiraLAX
Interactions Summary
  • 2 Major
  • 2 Moderate
  • 2 Minor
  • ondansetron
  • MiraLAX

Drug Interactions

Moderate
Ondansetron + Miralax

The following applies to the ingredients: Ondansetron and Polyethylene Glycol 3350 (found in Miralax)

MONITOR: Bowel cleansing as well as overuse of certain laxatives may cause electrolyte loss and increase the risk of torsade de pointes ventricular arrhythmia in patients treated with drugs that prolong the QT interval. Electrolyte disturbances including hypokalemia and hypomagnesemia have been reported with laxative abuse and are known risk factors for torsade de pointes associated with QT interval prolongation.

MANAGEMENT: Patients treated with drugs that prolong the QT interval should exercise caution when self-medicating with laxatives. The recommended dosage and duration of use should not be exceeded. Patients treated with lactulose for more than six months should be monitored periodically for electrolyte imbalance. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.

References

  1. Chin RL "Laxative-induced hypokalemia." Ann Emerg Med 32 (1998): 517-8
  2. Muller-Lissner SA "Adverse effects of laxatives: fact and fiction." Pharmacology 47 (1993): 138-45
  3. Canadian Pharmacists Association "e-CPS. http://www.pharmacists.ca/function/Subscriptions/ecps.cfm?link=eCPS_quikLink" (2006):
  4. Schaefer DC, Cheskin LJ "Constipation in the elderly." Am Fam Physician 58 (1998): 907-14

Drug and Food Interactions

Moderate
Miralax + Food

The following applies to the ingredients: Polyethylene Glycol 3350 (found in Miralax)

GENERALLY AVOID: Combining macrogol 3350 with starch-based food thickeners may counteract the thickening effect of starch-based thickener. According to some authorities, this may liquefy the preparations, potentially increasing the risk for aspiration in patients with swallowing problems.

MANAGEMENT: The direct mixing of macrogol 3350 with starch-based food thickeners should generally be avoided. Consultations with individual package labeling and relevant institutional protocols may be advisable for further guidance.

References

  1. "Product Information. MiraLax (polyethylene glycol 3350)." Bayer Consumer Health 3 (2021):
  2. "Product Information. OMNILAX (macrogol 4000)." PRO HEALTH PHARMA SWEDEN AB (2024):
  3. "Polyethylene glycol (PEG) laxatives and starch-based thickeners: potential interactive effect when mixed, leading to an increased risk of aspiration https://www.gov.uk/drug-safety-update/polyethylene-glycol-peg-laxatives-and-starch-based-thickeners-poten" (2021):

Drug and Pregnancy Interactions

The following applies to the ingredients: Ondansetron

Safety has not been established during pregnancy.

AU TGA pregnancy category: B1
US FDA pregnancy category: Not assigned

Risk summary: No data are available on the use of this drug in pregnant women to inform a drug-related risk.

Animal studies have failed to reveal evidence of fetal harm. There are no controlled data in human pregnancy.

AU TGA pregnancy category B1: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have not shown evidence of an increased occurrence of fetal damage.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out

References

  1. "Product Information. Zofran (ondansetron)." GlaxoSmithKline PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. "Product Information. Zuplenz (ondansetron)." Strativa Pharmaceuticals, a Division of Par Pharmaceuticals, Inc. (2010):

The following applies to the ingredients: Polyethylene Glycol 3350 (found in Miralax)

Use is not recommended unless clearly needed.

AU TGA pregnancy category: B1
US FDA pregnancy category: Not assigned

Animal studies have not been conducted. There are no controlled data in human pregnancy. Systemic exposure if negligible, so clinically significant exposure of the fetus is not expected.

AU TGA pregnancy category B1: Drugs which have been taken by only a limited number of pregnant women and women of childbearing age, without an increase in the frequency of malformation or other direct or indirect harmful effects on the human fetus having been observed. Studies in animals have not shown evidence of an increased occurrence of fetal damage.

US FDA pregnancy category Not Assigned: The US FDA has amended the pregnancy labeling rule for prescription drug products to require labeling that includes a summary of risk, a discussion of the data supporting that summary, and relevant information to help health care providers make prescribing decisions and counsel women about the use of drugs during pregnancy. Pregnancy categories A, B, C, D, and X are being phased out.

References

  1. Cerner Multum, Inc. "Australian Product Information." O 0
  2. TGA. Therapeutic Goods Administration. Australian Drug Evaluation Committee "Prescribing medicines in pregnancy: an Australian categorisation of risk of drug use in pregnancy. http://www.tga.gov.au/docs/html/medpreg.htm" (2010):
  3. Briggs GG, Freeman RK. "Drugs in Pregnancy and Lactation." Philadelphia, PA: Wolters Kluwer Health (2015):

Drug and Breastfeeding Interactions

The following applies to the ingredients: Ondansetron

Breastfeeding is not recommended during use of this drug (AU, UK)
Use with caution (US)

Excreted into human milk: Unknown
Excreted into animal milk: Yes

Comments: The effects in the nursing infant are unknown.

References

  1. "Product Information. Zofran (ondansetron)." GlaxoSmithKline PROD (2001):
  2. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
  3. Cerner Multum, Inc. "Australian Product Information." O 0
  4. "Product Information. Zuplenz (ondansetron)." Strativa Pharmaceuticals, a Division of Par Pharmaceuticals, Inc. (2010):
  5. United States National Library of Medicine "Toxnet. Toxicology Data Network. http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT" (2013):

The following applies to the ingredients: Polyethylene Glycol 3350 (found in Miralax)

This drug should be used only if clearly needed.

Excreted into human milk: Unknown
Excreted into animal milk: Unknown

References

  1. Cerner Multum, Inc. "Australian Product Information." O 0

Therapeutic Duplication Warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

Switch to: Consumer Interactions

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

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