What are ondansetron and Sotatic?
Ondansetron is an anti-nausea medication used to prevent nausea and vomiting that results from cancer chemotherapy. Chemotherapy agents cause increased secretion of serotonin, which stimulates serotonin (5-HT3) receptors in the brain, resulting in nausea and vomiting. Ondansetron works by selectively blocking serotonin (5-HT3) receptors, thereby reducing the effect of increased serotonin due to chemotherapy. It is also prescribed for prevention of nausea and vomiting after surgery.
Sotatic is a "prokinetic" drug that stimulates the muscles of the gastrointestinal tract including the muscles of the lower esophageal sphincter, stomach, and small intestine by interacting with receptors for acetylcholine and dopamine on gastrointestinal muscles and nerves. It is used in adults to relieve heartburn symptoms with gastroesophageal reflux when certain other treatments do not work and to relieve the symptoms of slow stomach emptying in people with diabetes.
Can Sotatic cause problems?
Along with their useful effects, all medicines can cause unwanted side-effects although not everyone experiences them. The table below lists some of the most common ones associated with Sotatic. You will find a full list in the manufacturer's information leaflet supplied with your medicine. The unwanted effects often improve over the first few days of taking a new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
What should I avoid while giving Sotatic to my pet:
Do not use Preventic Flea Collar on your pet while giving this medication.
Sotatic should not be used whenever stimulation of gastrointestinal motility might be dangerous, e.g., in the presence of gastrointestinal hemorrhage, mechanical obstruction, or perforation.
Sotatic is contraindicated in patients with pheochromocytoma because the drug may cause a hypertensive crisis, probably due to release of catecholamines from the tumor. Such hypertensive crises may be controlled by phentolamine.
Sotatic is contraindicated in patients with known sensitivity or intolerance to the drug. Sotatic should not be used in epileptics or patients receiving other drugs which are likely to cause extrapyramidal reactions, since the frequency and severity of seizures or extrapyramidal reactions may be increased.
Sotatic is generally administered orally in tablet or solution form. The dosage of the tablets and solutions is generally 5 to 10 mg. It is usually taken before meals and before sleep. However, in severely nauseous patients, it can be administered intramuscularly or intravenously, with the latter route taking effect much more quickly. Parenteral Sotatic is also generally 5 mg. Rectal administration is also an option, as is an intraperitoneal injection in patients undergoing peritoneal dialysis. In patients with kidney failure, it is generally recommended that maintenance doses of Sotatic be reduced to avoid drug accumulation.
Before taking this medicine
You should not use Sotatic if you are allergic to it, or if you have:
tardive dyskinesia (a disorder of involuntary movements);
stomach or intestinal problems such as a blockage, bleeding, or perforation (a hole or tear in your stomach or intestines);
epilepsy or other seizure disorder;
an adrenal gland tumor (pheochromocytoma); or
if you've ever had muscle movement problems after using Sotatic or similar medicines.
Tell your doctor if you have ever had:
liver or kidney disease;
problems with muscle movements;
congestive heart failure or a heart rhythm disorder;
depression or mental illness.
This medicine may contain phenylalanine. Check the medication label if you have phenylketonuria (PKU).
Tell your doctor if you are pregnant. Sotatic may harm an unborn baby if you use the medicine during late pregnancy.
It may not be safe to breast-feed a baby while you are using this medicine. Ask your doctor about any risks.
Sotatic is not approved for use by anyone younger than 18 years old.
How to use Sotatic Hcl
See also Warning section.
Read the Medication Guide provided by your pharmacist before you start taking Sotatic and each time you get a refill. If you have any questions, consult your doctor or pharmacist.
Take this medication by mouth 30 minutes before meals and at bedtime, usually 4 times daily or exactly as directed by your doctor. If you are using the liquid form of this medication, carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose.
If you are using the disintegrating tablet, do not remove the tablet from the blister pack until right before your dose. Dry your hands before using this medication. Do not use the tablet if it is broken or crumbled. Immediately after removing the tablet, place it on the tongue. Allow it to dissolve completely, then swallow it with saliva. You do not need to take this product with water.
The dosage is based on your medical condition, response to treatment, age, and other medications you may be taking. Be sure to tell your doctor and pharmacist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).
If heartburn only occurs at certain times (such as after the evening meal), your doctor may direct you to take a single dose before those times instead of taking it throughout the day. This will reduce your risk of side effects.
Because of the risk of tardive dyskinesia, do not take this more often, in larger doses, or for longer than directed by your doctor. According to the manufacturer, treatment should not exceed 12 weeks.
To treat diabetic gastroparesis, this medication is usually taken for 2 to 8 weeks until your gut is working well. This condition may recur from time to time. Your doctor may direct you to start taking this medication as soon as your symptoms reappear and stop when you feel better. Ask your doctor for directions for starting and stopping this medication.
Take this medication regularly as directed to get the most benefit from it. To help you remember, take it at the same times before a meal each day.
If you suddenly stop using this medication, you may have withdrawal symptoms (such as dizziness, nervousness, headaches). To help prevent withdrawal, your doctor may lower your dose slowly. Withdrawal is more likely if you have used Sotatic for a long time or in high doses. Tell your doctor or pharmacist right away if you have withdrawal.
Tell your doctor if your condition persists or worsens.
What should I avoid while taking Sotatic?
Drinking alcohol with this medicine can cause side effects.
Avoid driving or hazardous activity until you know how this medicine will affect you. Your reactions could be impaired.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
- Depression and suicide. Symptoms can include:
- lack of motivation
- thoughts of harming or killing yourself
- high fever
- stiff muscles
- trouble thinking
- fast or irregular heart rate
- increased sweating
Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
Sotatic oral tablet can interact with other medications, vitamins, or herbs you may be taking. An interaction is when a substance changes the way a drug works. This can be harmful or prevent the drug from working well.
To help avoid interactions, your doctor should manage all of your medications carefully. Be sure to tell your doctor about all medications, vitamins, or herbs you’re taking. To find out how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.
Examples of drugs that can cause interactions with Sotatic are listed below.
Do not use this medicine if you've ever had muscle movement problems after using Sotatic or similar medicines, or if you've had a movement disorder called tardive dyskinesia. You also should not use this medicine if you've had stomach or intestinal problems (a blockage, bleeding, or a hole or tear), epilepsy or other seizure disorder, or an adrenal gland tumor (pheochromocytoma).
NEVER USE METOCLOPRAMIDE IN LARGER AMOUNTS THAN RECOMMENDED, OR FOR LONGER THAN 12 WEEKS. High doses or long-term use can cause a serious movement disorder that may not be reversible. The longer you use Sotatic, the more likely you are to develop this movement disorder. The risk of this side effect is higher in diabetics and older adults (especially women).
Before you take Sotatic, tell your doctor if you have kidney or liver disease, congestive heart failure, high blood pressure, diabetes, Parkinson's disease, or a history of depression.
Do not drink alcohol. It can increase some of the side effects of Sotatic.
Stop using Sotatic and call your doctor at once if you have tremors or uncontrolled muscle movements, fever, stiff muscles, confusion, sweating, fast or uneven heartbeats, rapid breathing, depressed mood, thoughts of suicide or hurting yourself, hallucinations, anxiety, agitation, seizure, or jaundice (yellowing of your skin or eyes).
Mechanism of Action
Sotatic works by antagonizing central and peripheral dopamine two receptors in the medullary chemoreceptor trigger zone in the area postrema that are normally stimulated by levodopa or apomorphine. It achieves this by decreasing the sensitivity of visceral afferent nerves that transmit from the gastrointestinal system to the vomiting center in the area postrema in the chemoreceptor trigger zone . Sotatic also blocks the antiperistaltic effects of apomorphine, which allows Sotatic to slow apomorphine’s inhibition of gastric emptying, thereby accelerating gastric emptying by increasing the amplitude and duration of esophageal contractions. This also increases the resting tone of the lower esophageal sphincter while simultaneously relaxing the duodenal bulb and pyloric sphincter, thereby increasing peristalsis of the duodenum and jejunum. In addition to antagonizing dopamine and apomorphine, Sotatic also acts against type 3 serotonin receptors, though it has a weaker effect on these receptors than on the aforementioned dopamine and apomorphine receptors.
What preparations of Sotatic are available?
Tablets: 5 and 10 mg.Syrup: 5 mg/5 ml.Injection: 5 mg/ml