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These actions cause a decrease in circulating serotonin at the chemoreceptor trigger zone, reducing the symptoms of nausea and vomiting in affected patients.107,108 Ondansetron is metabolized in the liver by CYP3A4, CYP1A2, and CYP2D6, and excreted by the kidneys.109 Numerous data show the efficacy of this agent in nausea and vomiting induced by chemotherapy and in the postoperative period.110,111 The expert committee of the American Neurogastroenterology and Motility Society and the Cyclic Vomiting Syndrome Association recommend ondansetron as a first-line agent for aborting an episode of CVS