Ondansetron Is as Good as Promethazine for Treating Nausea in the ED

Ondansetron is used widely for postoperative and chemotherapy-related nausea and vomiting, but emergency department adoption has lagged somewhat, mostly because of the high cost of the drug and the effectiveness of other available agents, such as promethazine and prochlorperazine. In a randomized, double-blind, noninferiority trial, funded by the maker of ondansetron, researchers compared ondansetron with promethazine for treatment of undifferentiated nausea and vomiting in ED patients.

A convenience sample of 120 nonpregnant adults with nausea scores >40 on a validated 100-mm visual analog scale (VAS) received either promethazine (25 mg) or ondansetron (4 mg) intravenously. At 30 minutes, both groups had similar reductions in nausea scores …