Ondansetron to reduce neonatal opioid withdrawal severity a randomized clinical trial

Gary Peltz, Lauren M. Jansson, Susan Adeniyi-Jones, Carol Cohane, David Drover, Steven Shafer, Meiyue Wang, Manhong Wu, Balaji Govindaswami, Priya Jegatheesan, Cynthia Argani, Salwa Khan, Walter K. Kraft

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To determine if treatment with a 5-HT3 antagonist (ondansetron) reduces need for opioid therapy in infants at risk for neonatal opioid withdrawal syndrome (NOWS). Study design: A multicenter, randomized, placebo controlled, double blind clinical trial of ninety (90) infants. The intervention arms were intravenous ondansetron or placebo during labor followed by a daily dose of ondansetron or placebo in infants for five days. Results: Twenty-two (49%) ondansetron-treated and 26 (63%) placebo-treated infants required pharmacologic treatment (p > 0.05). The Finnegan score was lower in the ondansetron-treated group (4.6 vs. 5.6, p = 0.02). A non-significant trend was noted for the duration of hospitalization. There was no difference in need for phenobarbital or clonidine therapy, or total dose of morphine in the first 15 days of NOWS treatment. Conclusions: Ondansetron treatment reduced the severity of NOWS symptoms; and there was an indication that it could reduce the length of stay. Clinical Trial Registration: Clinicaltrials.gov

Original languageEnglish (US)
Pages (from-to)271-276
Number of pages6
JournalJournal of Perinatology
Volume43
Issue number3
DOIs
StatePublished - Mar 2023

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Pediatrics, Perinatology, and Child Health

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