Ondansetron is a potent inhibitor of 5-HT3 receptors, effectively mitigating nausea and vomiting but also showing a profound influence on cardiac physiology. Research reveals that ondansetron blocks small-conductance Ca2+-activated K+ (SK) channels, pivotal in cardiac repolarization, particularly under reduced repolarization reserve. Its ability to inhibit SK currents at therapeutic levels highlights its promise in managing arrhythmias caused by excessive SK activity. However, its association with drug-induced long QT syndrome (diLQTS) raises concerns about its role in prolonging cardiac repolarization. Studies show ondansetron inhibits both native and genetically altered SK channels, including KCNN2 variants, contributing to QT prolongation in predisposed patients. Observations in murine hearts and human cell models validate its dual effects, reinforcing the need for judicious use in patients with genetic or cardiac vulnerabilities.
Ko, J.-S., Guo, S., Hassel, J., Celestino-Soper, P., Lynnes, T.C., Tisdale, J.E., Zheng, J.J., Taylor, S.E., Foroud, T., Murray, M.D., Kovacs, R.J., Li, X., Lin, S.-F., Chen, Z., Vatta, M., Chen, P.-S. and Rubart, M., 2018. Ondansetron and its effects on IKAS and long QT syndrome. American Journal of Physiology - Heart and Circulatory Physiology.
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Ko, J.-S., Guo, S., Hassel, J., Celestino-Soper, P., Lynnes, T.C., Tisdale, J.E., Zheng, J.J., Taylor, S.E., Foroud, T., Murray, M.D., Kovacs, R.J., Li, X., Lin, S.-F., Chen, Z., Vatta, M., Chen, P.-S. and Rubart, M., 2018. Ondansetron and its effects on IKAS and long QT syndrome. American Journal of Physiology - Heart and Circulatory Physiology.
Ko, J.-S., Guo, S., Hassel, J., Celestino-Soper, P., Lynnes, T.C., Tisdale, J.E., Zheng, J.J., Taylor, S.E., Foroud, T., Murray, M.D., Kovacs, R.J., Li, X., Lin, S.-F., Chen, Z., Vatta, M., Chen, P.-S. and Rubart, M., 2018. Ondansetron and its effects on IKAS and long QT syndrome. American Journal of Physiology - Heart and Circulatory Physiology.
Ko, J.-S., Guo, S., Hassel, J., Celestino-Soper, P., Lynnes, T.C., Tisdale, J.E., Zheng, J.J., Taylor, S.E., Foroud, T., Murray, M.D., Kovacs, R.J., Li, X., Lin, S.-F., Chen, Z., Vatta, M., Chen, P.-S. and Rubart, M., 2018. Ondansetron and its effects on IKAS and long QT syndrome. American Journal of Physiology - Heart and Circulatory Physiology.