{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T19:06:20Z","timestamp":1780686380146,"version":"3.54.1"},"reference-count":211,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T00:00:00Z","timestamp":1767052800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["ascpt.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clin Pharma and Therapeutics"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:p>\n                    Ondansetron frequently triggers medication safety alerts because of its listing as a \u2018known risk\u2019 QT interval\u2010prolonging medication. We aimed to summarize literature on QT\u2010prolongation\u2010related major adverse cardiac events associated with ondansetron. We searched Medline, Embase, International Pharmaceutical Abstracts, and Cochrane Central for randomized controlled trials comparing ondansetron to placebo in adults. Major adverse cardiac events (MACE) included death, nonfatal cardiac arrest, ventricular tachyarrhythmia including torsades de pointes, seizure, or syncope. Random\u2010effects meta\u2010analyses were performed with a treatment arm continuity correction for single\u2010 and double\u2010zero event studies. We included 170 randomized trials (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200923,421, 70.7% female, 48.3% aged &gt;65), 119 trials (70.0%) involving surgical patients, and 77 (45.4%) including electrocardiograms. Mean follow\u2010up was 10\u2009days (SD: 21.8) (median: 1\u2009day). Risk of bias was high for 11.8% of trials, and low for 28.8%. Only seven MACE (all deaths) were reported. Ondansetron was not associated with increased mortality (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200923,421, RR: 1.03, 95% CI: 0.76\u20131.39,\n                    <jats:italic>I<\/jats:italic>\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20090.0%), or arrhythmias. Lack of events precluded prespecified meta\u2010analyses. Further research on QT\u2010prolonging medications and their attributed adverse cardiac events and medication alert optimization is needed.\n                  <\/jats:p>","DOI":"10.1002\/cpt.70189","type":"journal-article","created":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T07:59:57Z","timestamp":1767167997000},"page":"905-915","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Major Adverse Cardiac Events with Ondansetron: A Systematic Review"],"prefix":"10.1002","volume":"119","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0564-8776","authenticated-orcid":false,"given":"Michael Cristian","family":"Garcia","sequence":"first","affiliation":[{"name":"Clinical Pharmacology &amp; Toxicology Research Group Research Institute of St Joe\u2019s Hamilton  Hamilton Canada"},{"name":"Faculty of Medicine University of Toronto  Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-5925-6602","authenticated-orcid":false,"given":"Bhavya","family":"Gandhi","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology &amp; Toxicology Research Group Research Institute of St Joe\u2019s Hamilton  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3686-9077","authenticated-orcid":false,"given":"Faisal","family":"Quadri","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology &amp; Toxicology Research Group Research Institute of St Joe\u2019s Hamilton  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-2076-9519","authenticated-orcid":false,"given":"Mahnoor","family":"Shahab","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology &amp; Toxicology Research Group Research Institute of St Joe\u2019s Hamilton  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8962-1492","authenticated-orcid":false,"given":"Kassie","family":"Rong","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology &amp; 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Toxicology Research Group Research Institute of St Joe\u2019s Hamilton  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4323-3901","authenticated-orcid":false,"given":"Sara","family":"Mojdehi","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology &amp; Toxicology Research Group Research Institute of St Joe\u2019s Hamilton  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5855-5461","authenticated-orcid":false,"given":"Lawrence","family":"Mbuagbaw","sequence":"additional","affiliation":[{"name":"Department of Health Research Methods, Evidence, and Impact McMaster University  Hamilton Canada"},{"name":"Biostatistics Unit, Father Sean O\u2019Sullivan Research Centre, St Joseph\u2019s Healthcare  Hamilton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3371-4187","authenticated-orcid":false,"given":"Anne M.","family":"Holbrook","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology &amp; 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