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Discussion

Dilaudid & Zofran?

Can IV dilaudid and zofran be administered back to back? I've read in a few online resources that they could interact to potentiate drowsiness/dizziness/etc with serotonin syndrome being the worst adverse effect.

Experienced nurses, would you administer these meds together in common practice? Stagger them? Choose another antiemetic? Thanks in advance for your opinion!

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    I have given those many many times together with no problem. Of course it depends on the pt condition, other meds on board, and doses etc.

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    Based on the pharmacodynamics of Zofran, I don't see how it could cause either serotonin syndrome or drowsiness. I've never heard of this.

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    I give it together frequently in the PACU. Are you thinking of Phenergan with Dilaudid?

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    I've been given Zofran with Dilaudid on more than one occasion, and it was wonderful stuff. It prevents nausea, which Dilaudid is known to cause, without making me stupid (the Dilaudid accomplishes that quite nicely, haha!).

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    Dilaudid & Zofran... I’ve given them together hundreds of times in the ED ( or maybe ...thousands)???

    Never seen serotonin syndrome in my patients. But you made me curious so I also looked at online resources. In addition to Dilaudid, they also list Serotonin syndrome as a RARE reaction between Zofran and morphine, Fentanyl & Meperidine (which I rarely see ordered nowadays).

    It’s interesting...Serotonin syndrome isn’t listed as a potential reaction between Phenergan & those narcotics. (But Phenergan is a different drug class than zofran).

    That said- Phenergan IV is the 2nd or 3rd line choice of our ED docs. Zofran is #1. If symptoms persist, they may try IV Compazine, Phenergan, or Reglan (or a 2nd dose of zofran).

    I’ve been an ICU/ED nurse for 27 years, being “on the floor” for 22 of those years. Administered IV Dilaudid & Zofran back to back countless times. The past 5 years I’ve had an ED Case Manager job but still see countless ED & Inpatient orders for Dilaudid/ Zofran.

    No worries here! ?

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