Generic Name
Ondansetron
Brand Names
Ondansetron ODT, Sumansetron
FDA approval date: November 07, 2006
Classification: Serotonin-3 Receptor Antagonist
Form: Injection, Tablet, Kit, Solution
What is Ondansetron ODT (Ondansetron)?
Nausea and vomiting can make recovery from illness or treatment incredibly difficult. Whether it’s caused by chemotherapy, surgery, or severe gastroenteritis, these symptoms can drain strength, delay healing, and reduce quality of life. Ondansetron ODT (orally disintegrating tablet) helps bring relief to patients facing these challenges by preventing nausea and vomiting before they start.
Ondansetron ODT belongs to a class of medications called serotonin 5-HT₃ receptor antagonists, or simply antiemetics. It works by blocking certain chemical signals in the body that trigger nausea and vomiting. The ODT (orally disintegrating tablet) form dissolves quickly on the tongue without the need for water, making it especially useful for patients who can’t swallow pills or are actively feeling sick.
First approved by the U.S. Food and Drug Administration (FDA) in the early 1990s, ondansetron has become a trusted, first-line medication for preventing nausea and vomiting in both adults and children undergoing chemotherapy, radiation therapy, or surgery. Its safety, effectiveness, and convenience make it a mainstay in modern supportive care.
What does Ondansetron ODT do?
Ondansetron ODT is prescribed to prevent and treat nausea and vomiting caused by various medical treatments and conditions. Its most common uses include:
- Chemotherapy-induced nausea and vomiting (CINV): Many cancer patients receive ondansetron before chemotherapy to prevent the intense nausea that certain chemotherapy drugs can trigger.
- Postoperative nausea and vomiting (PONV): After surgery, some people experience nausea due to anesthesia or pain medications. Ondansetron helps reduce this risk.
- Radiation therapy–related nausea: It can help patients undergoing radiation treatment, especially those receiving therapy near the stomach or brain.
- Gastroenteritis or viral infections: In some cases, doctors may prescribe ondansetron to help manage severe vomiting so that patients can stay hydrated.
Clinical studies have shown that ondansetron significantly reduces both the frequency and severity of nausea and vomiting compared with placebo (NIH, 2024). Patients typically report relief within 30 minutes of taking the medication, allowing them to eat, drink, and recover more comfortably.
How does Ondansetron ODT work?
Ondansetron ODT works by blocking serotonin (5-HT₃), a natural chemical messenger involved in triggering nausea and vomiting.
During chemotherapy, surgery, or gastrointestinal irritation, the body releases serotonin in the gut. This serotonin activates 5-HT₃ receptors in the brain’s vomiting center and along the vagus nerve, sending signals that cause nausea and the urge to vomit. Ondansetron blocks these receptors, preventing those signals from reaching the brain.
By interrupting this pathway, ondansetron helps patients feel more stable and comfortable during treatment or recovery. Clinically, this is important because preventing nausea not only improves comfort but also helps patients stick to their prescribed treatments, especially in cancer therapy where maintaining nutrition and hydration is critical.
The ODT form offers added convenience, it dissolves on the tongue within seconds, making it easy for patients who can’t keep water down or have difficulty swallowing pills.
Ondansetron ODT side effects
Most people tolerate ondansetron ODT well, but like all medications, it can cause side effects.
Common side effects include:
- Headache
- Fatigue or mild drowsiness
- Constipation
- Dizziness
- Flushing or a warm feeling
Less common but potentially serious side effects:
- Irregular heartbeat or chest pain
- Fainting or severe dizziness
- Blurred vision or temporary vision loss (rare, usually with IV use)
- Signs of an allergic reaction such as rash, itching, or difficulty breathing
Ondansetron can affect heart rhythm, so those with congenital long QT syndrome, heart disease, or on QT-prolonging medications need medical supervision. Patients with liver impairment may require lower doses. Those with severe constipation or intestinal blockage should discuss risks before treatment.
If severe dizziness, fainting, or signs of allergic reaction occur, medical attention should be sought immediately. Fortunately, such reactions are rare, and ondansetron is considered a safe and well-tolerated medication when used as directed.
Ondansetron ODT dosage
Ondansetron ODT is a dissolvable tablet taken by mouth, once or multiple times daily, depending on the cause of nausea. Strengths vary based on patient needs. Let the tablet dissolve completely, peel back foil to remove, and store in a cool, dry place, handling with dry hands.
Doctors may monitor electrolytes and heart rhythm in patients with cardiac history or on multiple medications. Liver disease patients may require dosage adjustments. Ondansetron is safe for older adults and children, with healthcare provider-guided dosing.
Does Ondansetron ODT have a generic version?
Yes. Ondansetron ODT is available in generic form and is FDA-approved in the United States. The generic version contains the same active ingredient, strength, and effectiveness as the brand-name drug, Zofran ODT.
Generic ondansetron ODT is a more affordable, equally safe, and effective alternative to the brand-name version, meeting FDA standards. Other forms like oral tablets, solutions, and injectables are also available for different patient needs.
Conclusion
Ondansetron ODT is a trusted and effective medication that provides fast relief from nausea and vomiting caused by chemotherapy, surgery, or other medical conditions. By blocking serotonin receptors that trigger these symptoms, it helps patients maintain comfort, hydration, and energy during recovery or ongoing treatment.
Ondansetron ODT, an easy-to-take dissolving tablet, helps those unable to swallow pills or keep liquids down. Side effects are usually mild and temporary, and communication with a healthcare provider ensures safe and effective treatment. Used in various settings, it offers relief, allowing patients to focus on healing..
References
- U.S. Food and Drug Administration (FDA). (2024). Ondansetron ODT prescribing information. Retrieved from https://www.accessdata.fda.gov
- Mayo Clinic. (2024). Ondansetron (oral route) description and precautions. Retrieved from https://www.mayoclinic.org
- MedlinePlus. (2024). Ondansetron: Drug information. National Library of Medicine. Retrieved from https://medlineplus.gov
- National Institutes of Health (NIH). (2024). Serotonin receptor antagonists and antiemetic therapy. Retrieved from https://www.nih.gov
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Brand Information
Ondansetron (Ondansetron)
1Indications and Usage Section
1 INDICATIONS AND USAGE
Ondansetron orally disintegrating tablets are indicated for the prevention of nausea and vomiting associated with:
highly emetogenic cancer chemotherapy, including cisplatin greater than or equal to 50 mg/m2
Ondansetron orally disintegrating tablets also indicated for the prevention of postoperative nausea and/or vomiting.
2Dosage and Administration Section
2 DOSAGE AND ADMINISTRATION
2.1 Dosage
The recommended dosage regimens for adult and pediatric patients are described in Table 1 and Table 2, respectively.
Table 1: Adult Recommended Dosage Regimen for Prevention of Nausea and Vomiting
Table 2: Pediatric Recommended Dosage Regimen for Prevention of Nausea and Vomiting
2.2 Dosage in Hepatic Impairment
In patients with severe hepatic impairment (Child-Pugh score of 10 or greater), do not exceed a total daily dose of 8 mg [see USE IN SPECIFIC POPULATIONS (8.6), CLINICAL PHARMACOLOGY (12.3)].
2.3 Administration Instructions for Ondansetron Orally Disintegrating Tablets
Do not attempt to push ondansetron orally disintegrating tablets through the foil backing. With dry hands, remove the tablet from the bottle or PEEL BACK the foil backing of 1 blister and GENTLY remove the tablet. IMMEDIATELY place the ondansetron orally disintegrating tablet on top of the tongue where it will dissolve in seconds, then swallow with saliva. Administration with liquid is not necessary.
3Dosage Forms and Strengths
Ondansetron Orally Disintegrating Tablets USP, 4 mg are white to off-white, round tablets debossed with ‘5’ on one side and ‘E’ on the other side with an embossed circular edge.
Ondansetron Orally Disintegrating Tablets USP, 8 mg are white to off-white, round tablets debossed with ‘7’ on one side and ‘E’ on the other side with an embossed circular edge.
4Contraindications
Ondansetron orally disintegrating tablets are contraindicated in patients:
known to have hypersensitivity (e.g., anaphylaxis) to ondansetron or any of the components of the formulation [see ADVERSE REACTIONS (6.2)]
5Warnings and Precautions
5.1 Hypersensitivity Reactions
Hypersensitivity reactions, including anaphylaxis and bronchospasm, have been reported in patients who have exhibited hypersensitivity to other selective 5-HT3 receptor antagonists. If hypersensitivity reactions occur, discontinue use of ondansetron; treat promptly per standard of care and monitor until signs and symptoms resolve [see CONTRAINDICATIONS (4)].
5.2 QT Prolongation
Electrocardiogram (ECG) changes, including QT interval prolongation have been seen in patients receiving ondansetron. In addition, postmarketing cases of Torsade de Pointes have been reported in patients using ondansetron. Avoid ondansetron in patients with congenital long QT syndrome. ECG monitoring is recommended in patients with electrolyte abnormalities (e.g., hypokalemia or hypomagnesemia), congestive heart failure, bradyarrhythmias, or patients taking other medicinal products that lead to QT prolongation [see CLINICAL PHARMACOLOGY (12.2)].
5.3 Serotonin Syndrome
The development of serotonin syndrome has been reported with 5-HT3 receptor antagonists alone. Most reports have been associated with concomitant use of serotonergic drugs (e.g., selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), monoamine oxidase inhibitors, mirtazapine, fentanyl, lithium, tramadol, and intravenous methylene blue). Some of the reported cases were fatal. Serotonin syndrome occurring with overdose of ondansetron alone has also been reported. The majority of reports of serotonin syndrome related to 5-HT3 receptor antagonist use occurred in a post-anesthesia care unit or an infusion center.
5.4 Masking of Progressive Ileus and Gastric Distension
The use of ondansetron in patients following abdominal surgery or in patients with chemotherapy-induced nausea and vomiting may mask a progressive ileus and/or gastric distension. Monitor for decreased bowel activity, particularly in patients with risk factors for gastrointestinal obstruction.
5.5 Phenylketonuria
Phenylketonuric patients should be informed that ondansetron orally disintegrating tablets contain phenylalanine (a component of aspartame). Each 4 mg orally disintegrating tablet contains 1.68 mg phenylalanine and 8 mg orally disintegrating tablet contains 3.37 mg phenylalanine.
6Adverse Reactions Section
6 ADVERSE REACTIONS
6.1 Clinical Trials Experience
Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared with rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Table 3: Most Common Adverse Reactions in Adultsa for the Prevention of Nausea and Vomiting Associated with Moderately Emetogenic Chemotherapy [Primarily Cyclophosphamide-based Regimens]
Less Common Adverse Reactions
Table 4: Most Common Adverse Reactions in Adultsa for the Prevention of Postoperative Nausea and Vomiting
In a crossover study with 25 subjects, headache was reported in 6 subjects administered ondansetron orally disintegrating tablets with water (24%) as compared with 2 subjects administered ondansetron orally disintegrating tablets without water (8%).
6.2 Postmarketing Experience
The following adverse reactions have been identified during post-approval use of ondansetron. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
7Drug 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-HT3 receptor antagonists and other serotonergic drugs, including SSRIs and SNRIs. Monitor for the emergence of serotonin syndrome. If symptoms occur, discontinue ondansetron and initiate supportive treatment [see WARNINGS AND PRECAUTIONS (5.3)].
7.2 Drugs Affecting Cytochrome P-450 Enzymes
Ondansetron does not itself appear to induce or inhibit the cytochrome P-450 drug-metabolizing enzyme system of the liver [see CLINICAL PHARMACOLOGY (12.3)]. Because ondansetron is metabolized by hepatic cytochrome P-450 drug-metabolizing enzymes (CYP3A4, CYP2D6, CYP1A2), inducers or inhibitors of these enzymes may change the clearance and, hence, the half-life of ondansetron. In patients treated with potent inducers of CYP3A4 (i.e., phenytoin, carbamazepine, and rifampin), the clearance of ondansetron was significantly increased and ondansetron blood concentrations were decreased. However, on the basis of available data, no dosage adjustment for ondansetron is recommended for patients on these drugs [see CLINICAL PHARMACOLOGY (12.3)].
7.3 Tramadol
Although no pharmacokinetic drug interaction between ondansetron and tramadol has been observed, data from 2 small trials indicate that when used together, ondansetron may increase patient-controlled administration of tramadol. Monitor patients to ensure adequate pain control when ondansetron is administered with tramadol.
7.4 Chemotherapy
Carmustine, etoposide, and cisplatin do not affect the pharmacokinetics of ondansetron.
7.5 Alfentanil and Atracurium
Ondansetron does not alter the respiratory depressant effects produced by alfentanil or the degree of neuromuscular blockade produced by atracurium. Interactions with general or local anesthetics have not been studied.
8Use in Specific Populations
8.1 Pregnancy
Risk Summary
Published epidemiological studies on the association between ondansetron use and major birth defects have reported inconsistent findings and have important methodological limitations that preclude conclusions about the safety of ondansetron use in pregnancy (see Data). Available postmarketing data have not identified a drug-associated risk of miscarriage or adverse maternal outcomes. Reproductive studies in rats and rabbits did not show evidence of harm to the fetus when ondansetron was administered during organogenesis at approximately 6 and 24 times the maximum recommended human oral dose of 24 mg/day, based on body surface area, respectively (see Data).
The background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, miscarriages, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriages in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively.
Data
Human Data
Available data on ondansetron use in pregnant women from several published epidemiological studies preclude an assessment of a drug-associated risk of adverse fetal outcomes due to important methodological limitations, including the uncertainty of whether women who filled a prescription actually took the medication, the concomitant use of other medications or treatments, recall bias, and other unadjusted confounders.
Ondansetron exposure in utero has not been associated with overall major congenital malformations in aggregate analyses. One large retrospective cohort study examined 1970 women who received a prescription for ondansetron during pregnancy and reported no association between ondansetron exposure and major congenital malformations, miscarriage, stillbirth, preterm delivery, infants of low birth weight, or infants small for gestational age.
Two large retrospective cohort studies and one case-control study have assessed ondansetron exposure in the first trimester and risk of cardiovascular defects with inconsistent findings. Relative risks (RR) ranged from 0.97 (95% CI 0.86 to 1.10) to 1.62 (95% CI 1.04, 2.54). A subset analysis in one of the cohort studies observed that ondansetron was specifically associated with cardiac septal defects (RR 2.05, 95% CI 1.19, 3.28); however, this association was not confirmed in other studies.
Several studies have assessed ondansetron and the risk of oral clefts with inconsistent findings. A retrospective cohort study of 1.8 million pregnancies in the U.S. Medicaid Database showed an increased risk of oral clefts among 88,467 pregnancies in which oral ondansetron was prescribed in the first trimester (RR 1.24, 95% CI 1.03, 1.48), but no such association was reported with intravenous ondansetron in 23,866 pregnancies (RR 0.95, 95% CI 0.63, 1.43). In the subgroup of women who received both forms of administration, the RR was 1.07 (95% CI 0.59, 1.93). Two case-control studies, using data from birth defects surveillance programs, reported conflicting associations between maternal use of ondansetron and isolated cleft palate (OR 1.6 [95% CI 1.1, 2.3] and 0.5 [95% CI 0.3, 1.0]). It is unknown whether ondansetron exposure in utero in the cases of cleft palate occurred during the time of palate formation (the palate is formed between the 6th and 9th weeks of pregnancy).
Animal Data
In embryo-fetal development studies in rats and rabbits, pregnant animals received oral doses of ondansetron up to 15 mg/kg/day and 30 mg/kg/day, respectively, during the period of organogenesis. With the exception of a slight decrease in maternal body weight gain in the rabbits, there were no significant effects of ondansetron on the maternal animals or the development of the offspring. At doses of 15 mg/kg/day in rats and 30 mg/kg/day in rabbits, the maternal exposure margin was approximately 6 and 24 times the maximum recommended human oral dose of 24 mg/day, respectively, based on body surface area.
In a pre- and postnatal developmental toxicity study, pregnant rats received oral doses of ondansetron up to 15 mg/kg/day from Day 17 of pregnancy to litter Day 21. With the exception of a slight reduction in maternal body weight gain, there were no effects upon the pregnant rats and the pre- and postnatal development of their offspring, including reproductive performance of the mated F1 generation. At a dose of 15 mg/kg/day in rats, the maternal exposure margin was approximately 6 times the maximum recommended human oral dose of 24 mg/day, based on body surface area.
8.2 Lactation
Risk Summary
8.4 Pediatric Use
The safety and effectiveness of orally administered ondansetron have been established in pediatric patients 4 years and older for the prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy. Use of ondansetron in these age-groups is supported by evidence from adequate and well- controlled studies of ondansetron in adults with additional data from 3 open-label, uncontrolled, non-U.S. trials in 182 pediatric patients aged 4 to 18 years with cancer who were given a variety of cisplatin or noncisplatin regimens [see DOSAGE AND ADMINISTRATION (2.2), CLINICAL STUDIES (14.1)].
prevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy
8.5 Geriatric Use
Of the total number of subjects enrolled in cancer chemotherapy-induced and postoperative nausea and vomiting in U.S.- and foreign-controlled clinical trials, for which there were subgroup analyses, 938 (19%) were aged 65 years and older.
8.6 Hepatic Impairment
No dosage adjustment is needed in patients with mild or moderate hepatic impairment.
8.7 Renal Impairment
No dosage adjustment is recommended for patients with any degree of renal impairment (mild, moderate, or severe). There is no experience beyond first-day administration of ondansetron [see CLINICAL PHARMACOLOGY (12.3)].
9Drug Abuse and Dependence
Animal studies have shown that ondansetron is not discriminated as a benzodiazepine nor does it substitute for benzodiazepines in direct addiction studies.
10Overdosage
There is no specific antidote for ondansetron overdose. Patients should be managed with appropriate supportive therapy.
11Description
The active ingredient in ondansetron orally disintegrating tablets, USP is ondansetron base, the racemic form of ondansetron and a selective blocking agent of the serotonin 5-HT3 receptor type. Chemically it is (±) 1, 2, 3, 9-tetrahydro-9-methyl-3-[(2-methyl-1H-imidazol-1-yl)methyl]-4H-carbazol-4-one. It has the following structural formula:
The molecular formula is C18H19N3O representing a molecular weight of 293.4 g/mol. Ondansetron is a white to off-white powder.
Each 4 mg ondansetron orally disintegrating tablet, USP for oral administration contains 4 mg ondansetron base. Each 8 mg ondansetron orally disintegrating tablet, USP for oral administration contains 8 mg ondansetron base. Each ondansetron orally disintegrating tablet, USP also contains the inactive ingredients mannitol, crospovidone, lactose monohydrate, microcrystalline cellulose, aspartame, strawberry guarana flavor, colloidal silicon dioxide, and magnesium stearate. The strawberry guarana flavor contains maltodextrin, propylene glycol, artificial flavors, and acetic acid. Ondansetron orally disintegrating tablets, USP are orally administered formulation of ondansetron which disintegrates on the tongue and does not require water to aid dissolution or swallowing.
Meets USP Disintegration Test 2.
12Clinical Pharmacology
12.1 Mechanism of Action
Ondansetron is a selective 5-HT3 receptor antagonist. While its mechanism of action has not been fully characterized, ondansetron is not a dopamine-receptor antagonist. Serotonin receptors of the 5-HT3 type are present both peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone of the area postrema. It is not certain whether ondansetron’s antiemetic action is mediated centrally, peripherally, or in both sites. However, cytotoxic chemotherapy appears to be associated with release of serotonin from the enterochromaffin cells of the small intestine. In humans, urinary 5-hydroxyindoleacetic acid (5-HIAA) excretion increases after cisplatin administration in parallel with the onset of emesis. The released serotonin may stimulate the vagal afferents through the 5-HT3 receptors and initiate the vomiting reflex.
12.2 Pharmacodynamics
In healthy subjects, single intravenous doses of 0.15 mg/kg of ondansetron had no effect on esophageal motility, gastric motility, lower esophageal sphincter pressure, or small intestinal transit time. Multiday administration of ondansetron has been shown to slow colonic transit in healthy subjects. Ondansetron has no effect on plasma-prolactin concentrations.
12.3 Pharmacokinetics
Absorption
Table 5: Pharmacokinetics in Male and Female Healthy Subjects After a Single Dose of a Ondansetron 8 mg Tablet
Table 6: Pharmacokinetics in Male and Female Healthy Subjects After a Single Dose of a Ondansetron 24 mg Tablet
Renal Impairment: Renal impairment is not expected to significantly influence the total clearance of ondansetron as renal clearance represents only 5% of the overall clearance. However, the mean plasma clearance of ondansetron was reduced by about 50% in patients with severe renal impairment (creatinine clearance less than 30 mL/min). The reduction in clearance was variable and not consistent with an increase in half-life [see USE IN SPECIFIC POPULATIONS (8.7)].
13Non Clinical Toxicology
13.1 Carcinogenesis, Mutagenesis, Impairment of Fertility
Carcinogenic effects were not seen in 2-year studies in rats and mice with oral ondansetron doses up to 10 mg/kg per day and 30 mg/kg per day, respectively (approximately 4 and 6 times the maximum recommended human oral dose of 24 mg per day, based on body surface area).
14Clinical Studies
14.1 Prevention of Chemotherapy-Induced Nausea and Vomiting
Highly Emetogenic Chemotherapy
Table 7: Emetic Episodes-Treatment Response in Patients Receiving Moderately Emetogenic Chemotherapy (Cyclophosphamide-based Regimen Containing Doxorubicin)
a Median undefined since at least 50% of the patients were withdrawn or had more than 2 emetic episodes.
In a double-blind, U.S. trial in 336 patients receiving a cyclophosphamide-based chemotherapy regimen containing either methotrexate or doxorubicin, ondansetron 8 mg administered twice a day, was as effective as ondansetron 8 mg administered 3 times a day in preventing nausea and vomiting. Ondansetron 8 mg three times daily is not a recommended regimen for the treatment of moderately emetogenic chemotherapy [see DOSAGE AND ADMINISTRATION (2.1)].
Table 8: Emetic Episodes-Treatment Response after Ondansetron Tablets Administered Twice a Day and Three Times a Day
a The first 8 mg dose was administered 30 minutes before the start of emetogenic chemotherapy, with a subsequent 8 mg dose 8 hours after the first dose, followed by 8 mg administered twice a day for 2 days after the completion of chemotherapy.
Re-treatment
14.2 Radiation-Induced Nausea and Vomiting
Total Body Irradiation
14.3 Postoperative Nausea and Vomiting
In 2 placebo-controlled, double-blind trials (one conducted in the U.S. and the other outside the U.S.) in 865 females undergoing inpatient surgical procedures, ondansetron 16 mg as a single dose or placebo was administered one hour before the induction of general balanced anesthesia (barbiturate, opioid, nitrous oxide, neuromuscular blockade, and supplemental isoflurane or enflurane), ondansetron was significantly more effective than placebo in preventing postoperative nausea and vomiting.
No trials have been performed in males.
15How Supplied/Storage and Handling
Ondansetron Orally Disintegrating Tablets USP, 4 mg are white to off-white, round tablets debossed with ‘5’ on one side and ‘E’ on the other side with an embossed circular edge.
Bottles of 20 Tablets NDC 80425-0073-01
Bottles of 30 Tablets NDC 80425-0073-02
Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) [see USP Controlled Room Temperature]. Dispense in a tight, light-resistant container as defined in the USP.
16Patient Counseling Information
QT Prolongation
Instruct the patient to report the use of all medications, especially apomorphine, to their healthcare provider. Concomitant use of apomorphine and ondansetron may cause a significant drop in blood pressure and loss of consciousness.
Administration of Ondansetron Orally Disintegrating Tablets
Do not attempt to push ondansetron orally disintegrating tablets through the foil backing.
Distributed by:
Distributed by:
Advanced Rx Pharmacy of Tennessee LLC, Nashville, TN 37211
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