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Jon Faldasz: Ondansetron May Have Cardiotoxicity Risk Among 5-HT3RAs Due to High Concentration in Cardiac Tissues
Jon Faldasz/LinkedIn
Nov 21, 2025, 14:13

Jon Faldasz: Ondansetron May Have Cardiotoxicity Risk Among 5-HT3RAs Due to High Concentration in Cardiac Tissues

Jon Faldasz, Senior Director of Product and Customer Experience at InsightRX, posted on LinkedIn:

”Just dropped: Ondansetron may have outstanding cardiotoxicity risk among 5-HT3RAs due to high concentration in cardiac tissues

Published today in Nature Scientific Reports, Cai et al used the FDA’s Adverse Event Reporting System (FAERS) to review records of cardiotoxicity associated with 5-HT3RA use. They found:

– The different 5-HT3RAs exhibit varying degrees and types of cardiotoxicity
– QT prolongation was most common for ondansetron (granisetron was least common)
– In a subsequent PBPK model extrapolation they estimated that ondansetron concentrations in cardiac tissue were 2.3x higher than plasma.

They suggested that providers might “prioritize low cardiac toxicity 5-HT3RAs” (read: avoid ondansetron) in patients with heart disease.

For my part, FAERS seems like an untapped resource for this type of work, now I’m thinking on what other investigations could make use of it.

Article reference here.”

Title: Cardiotoxicity of different 5-HT3 receptor antagonists analyzed using the FAERS database and pharmacokinetic study

Authors: Yijun Cai, Shaohong Luo, Shen Lin, Xiaoting Huang, Xiangzhen Wang, Lijing Yang, Xiongwei Xu, Xiuhua Weng

Cardiotoxicity

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5-HT3RA Cardiology Cardiotoxicity FAERS Database FDA's Adverse Event Reporting System Headlines Health Heart Health Hematology Hemostasis Hemostasis Today InsightRX Jon Faldasz Lijing Yang Medicine Nature Nature Magazine Ondansetron QT Prolongation Shaohong Luo Shen Lin thrombosis Xiangzhen Wang Xiaoting Huang Xiongwei Xu Xiuhua Weng Yijun Cai
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