Two medicines, side by side
Metoclopramide vs ondansetron
Metoclopramide and ondansetron are both labeled for nausea and vomiting. Drugs@FDA records approvals of metoclopramide since 1979 and of ondansetron since 1991. Pharmacies paid $0.0439 per metoclopramide 10 mg tablet and $0.0582 per ondansetron HCl 4 mg tablet (NADAC, October 7, 2026); the strengths differ, so the two prices are not like for like. In FDA's classes, metoclopramide is a dopamine-2 receptor antagonist and ondansetron a serotonin-3 receptor antagonist.
Check it at the source: the metoclopramide FDA label on DailyMed (effective May 18, 2026); the ondansetron FDA label on DailyMed (effective January 8, 2026).
Highlights of the metoclopramide record
Metoclopramide (Reglan) · label of May 18, 2026
TARDIVE DYSKINESIA
Metoclopramide, including metoclopramide tablets, can cause tardive dyskinesia (TD), a potentially irreversible serious movement disorder. In patients treated with metoclopramide, including metoclopramide tablets, the risk of developing TD increases with duration of treatment and total cumulative dosage [see Warnings and Precautions ( 5.1 )].
Metoclopramide tablets are contraindicated in patients with a history of TD.
Used for
From the label: indicationsMetoclopramide Tablets USP are indicated for the: • Treatment for 4 to 12 weeks of symptomatic, documented gastroesophageal reflux in adults who fail to respond to conventional therapy. • Relief of symptoms in adults with acute and recurrent diabetic gastroparesis. […]
On the market
- Earliest approval on file
- February 7, 1979
- Generic labelers
- 39 labelers
- Pharmacy cost
- $0.0439 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 10
Highlights of the ondansetron record
Ondansetron (Zofran) · label of January 8, 2026
Used for
From the label: indicationsOndansetron is indicated for the prevention of nausea and vomiting associated with: • highly emetogenic cancer chemotherapy, including cisplatin greater than or equal to 50 mg/m 2 • initial and repeat courses of moderately emetogenic cancer chemotherapy • radiotherapy in patients receiving either total body irradiation, single high-dose fraction to the abdomen, or daily fractions to the abdomen Ondansetron is also indicated for the prevention of postoperative nausea and/or vomiting. […]
On the market
- Earliest approval on file
- January 4, 1991
- Generic labelers
- 77 labelers
- Pharmacy cost
- $0.0582 per tablet
Supply and safety
- Shortage
- No current entry
- Recalls
- 15
Source: FDA drug labels via openFDA (Metoclopramide label of May 18, 2026, Ondansetron label of January 8, 2026); NDC Directory, Drugs@FDA, NADAC, FDA shortages and recalls (October 8, 2026)
How do metoclopramide and ondansetron differ on the record?
In FDA's classes, metoclopramide is a dopamine-2 receptor antagonist and ondansetron a serotonin-3 receptor antagonist.
How each works, in its label's words: Metoclopramide, “Metoclopramide stimulates motility of the upper gastrointestinal tract without stimulating gastric, biliary, or pancreatic secretions.”; Ondansetron, “Ondansetron is a selective 5‑HT 3 receptor antagonist.”
Only the metoclopramide label carries a boxed warning.
Generics: metoclopramide since 1985; ondansetron since 2006 (Drugs@FDA).
| Metoclopramide | Ondansetron | |
|---|---|---|
| Labeled for | Acid reflux and ulcers, Nausea and vomiting | Nausea and vomiting |
| Pharmacologic class | Dopamine-2 Receptor Antagonist | Serotonin-3 Receptor Antagonist |
| How it works (label) | Metoclopramide stimulates motility of the upper gastrointestinal tract without stimulating gastric, biliary, or pancreatic secretions. | Ondansetron is a selective 5‑HT 3 receptor antagonist. While its mechanism of action has not been fully characterized, ondansetron is not a dopamine‑receptor antagonist. |
| Half-life (label) | The mean elimination half-life in subjects with normal renal function was 5 to 6 hours. | n/a |
| Earliest approval on file (Drugs@FDA) | February 7, 1979 | January 4, 1991 |
| First generic approved | July 29, 1985 | November 22, 2006 |
| Generic labelers (NDC) | 39 labelers | 77 labelers |
| Pharmacy cost (NADAC, each one's most listed form; strengths differ) | $0.0439 per tablet (Metoclopramide 10 mg tablet) | $0.0582 per tablet (Ondansetron HCl 4 mg tablet) |
| 12-month price change | -11% | -14% |
| Boxed warning | Yes | No |
| Shortage now | No current entry | No current entry |
| Recalls recorded | 10 | 15 |
| FAERS reports (a report is not proof of cause; counts follow how widely a medicine is used) | 76,710 | 121,842 |
| DEA schedule | none | none |
Source: Drugs@FDA, FDA NDC Directory, CMS NADAC of October 7, 2026, FDA shortages and recalls, FAERS via openFDA (FDA files October 8, 2026)
What do the labels say about using others of their kind?
Ondansetron label, drug interactionsDRUG INTERACTIONS 7.1 Serotonergic Drugs Serotonin syndrome (including altered mental status, autonomic instability, and neuromuscular symptoms) has been described following the concomitant use of 5-HT 3 receptor antagonists and other serotonergic drugs, including SSRIs and SNRIs.
Source: FDA drug labels via openFDA
What next?
- Alternatives to metoclopramide
- every medicine labeled for the same conditions