zofran vs phenergan?

[Nursetobe25]

Which do you prefer to give/ take and what do you think work better?

From people I've talked to it seems zofran is either a hit or miss with nausea especially once theyes are actively vomiting. But phenergan always seems to work quite well despite having more side effects like sedation and what not.

What do you think?

[VANurse2010]

Phenergan definitely works better, but obviously it has many more side effects and with its anti-cholinergic properties must be used more cautiously. My hospital system doesn't even keep IV Phenergan on formulary anymore. The go-to drug is now Tigan.

[RNperdiem, RN]

Outside of PACU, we don't see much of phenergan anymore. I once got a phenergan shot; that spot hurt for a month.

[Fruit Sucker]

Zofran. Phenergan is an old drug. And it can cause nasty headaches, which Zofran does not.

[SierraBravo]

Both drugs have completely different MOA's. To say that one is better than the other is completely subjective. What works for one patient may not work as well for another. I use both in my daily practice. I tend to try ondansetron first because of its non-sedating profile. If promethazine tends to work for a patient and you don't want to sedate them, you could ask for an order for prochloperazine; it's in the same class as promethazine but has far less of a chance of sedation.

[Jules A, MSN]

I think Zofran is one of the most bestest meds ever!

[Rose_Queen, BSN, MSN, RN]

Never had any luck with Zofran personally. Give my Compazine and I am a happy patient!

I work with a few anesthesiologists who prefer a pretty hefty antiemetic cocktail for patients prone to post-op nausea and vomiting: Zofran IV combined with a Phenergan suppository (placed after the patient is asleep, naturally). Apparently it works well in most cases.

[klone, MSN, RN]

Zofran use in first trimester has been associated with fetal cardiac anomalies. This is recent research that a lot of OB professionals haven't really caught onto yet, so I still see lots of pregnant women being Rx'ed zofran in the ED and by other providers.

Our facility has an algorithm we use for nausea and hyperemesis gravidarum. We start with "Diclegis" (our pharmacy doesn't carry it by brand name, so we just Rx B6 and doxylamine), then move onto PO or PR Phenergan, then PO/PR Reglan, and then we might try Compazine.

[That Guy, BSN, RN, EMT-B]

Succs. Oh wait that wasn't the question.

Since people are less inclined to prescribe phenergan lately, it has been zofran and benadryl/compazine.

[applewhitern, BSN, RN]

We are required to use zofran. If that doesn't work we can call for a phenergan order. Our docs took phenergan off our standing orders, and now will only give half doses. Also will not allow us to dilute and push, but require us to mix with 50cc and drip over 30 min.

[mmc51264, BSN, MSN, RN]

we usually have both to offer prn. Compazine in rare cases. Pt that like the buzz/sedation, always ask for phenergen.

[OneDuckyRN]

We still see the occasional order for Phenergan, but it's rarely given. You know, older patients, friable veins, don't want IMs, that sort of thing. Zofran seems to work pretty well for most of my patients, but for the really tough N/V patients, the docs on my floor seem to like Reglan 4x a day scheduled, with Zofran PRN. The only time I've seen it not work well is for someone with an ileus - nothing worked well for this guy.