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Use of Zofran®, Ondansetron Hexal®, Ondansetron Sandoz® (ondansetron) in early pregnancy and risk of birth defects

A Dear Healthcare Professional Letter has been issued by Novartis to inform healthcare professionals of the findings from recently published epidemiological studies related to the risk of birth defects associated with ondansetron. These studies assessed the risk of specific congenital anomalies, including orofacial clefts and cardiac malformations in children born to mothers exposed to ondansetron during the first trimester of pregnancy. An increase in orofacial clefts was observed in infants of women administered ondansetron during the first trimester of pregnancy. Regarding cardiac malformations, the epidemiological studies showed conflicting results. Healthcare professionals are advised to take into consideration the above safety information when prescribing Zofran®, Ondansetron Hexal® or Ondansetron Sandoz®. These products are not approved for the treatment of nausea and vomiting in pregnancy, and their use in pregnancy is not recommended. Women of childbearing potential should be advised to use contraception while taking Zofran®, Ondansetron Hexal® or Ondansetron Sandoz® and for 2 days after stopping treatment. Please refer to the letter for details.
Healthcare professional, Industry member, Therapeutic Products

Dear Healthcare Professional Letters

28 Sep 2020

Only abstracts of the Dear Healthcare Professional Letters (DHCPL) are provided on this website. Details of the letters can be found on the MOH Alert System, which is accessible via the Health Professionals Portal (HPP). HPP is a one-stop portal for all healthcare professionals in Singapore. Dentists, medical doctors and pharmacists may access HPP at, and follow the procedures below to access the MOH Alert system.

Step 1: On the top navigation ribbon of webpage, select 'For Healthcare Professionals' followed by 'Health Professionals Portal' and click on the choice of profession. User will be redirected to the specific HPP webpage for the selected profession.

Step 2: Click on the Restricted Content icon on the left panel of webpage and login via SingPass.

Step 3: Click on the MOH Alert icon under ‘Applications’ section

Step 4: Click on the Drug Alert tab to view the DHCPLs.