Classes
DEA Class; Rx
Common Brand Names; Aloxi
- Antiemetics, Selective 5-HT3 Antagonist
Description
Parenteral 5-HT3 receptor antagonist
Used for prevention of post-operative nausea and vomiting and acute and delayed chemotherapy-induced nausea and vomiting
Long half-life allows for one-time dosing within a 7-day period for CINV
Indications
Indicated for prevention of acute N/V associated with moderately or highly emetogenic chemotherapeutic agents; also for delayed N/V associated moderately emetogenic chemotherapeutic agents
Indicated for prevention of PONV following surgery; efficacy beyond 24 hr has not been demonstrated
Contraindications
Hypersensitivity to drug, other selective 5-HT3 receptor antagonists (eg, granisetron), or any other component
Coadministration with apomorphine; combination reported to cause profound hypotension and loss of consciousness
Adverse Effects
- Prolonged QT interval (up to 5%)
- Anxiety
- Dizziness
- Headache
- Weakness
- Constipation
- Diarrhea
- Prutitus
- Hyperkalemia
- LFT’s increased
- First degree atrioventricular block
- Second degree atrioventricular block
Warnings
Use caution in patients with congenital long QT syndrome or other factors that may prolong QT interval
Serotonin syndrome reported with 5-HT3 receptor antagonists alone but particularly with concomitant use of serotonergic drugs including SSRIs, SNRIs, MAO inhibitors, lithium, tramadol, methylene blue IV, and mirtazapine
Hypersensitivity reactions, including anaphylaxis, reported with or without known hypersensitivity to other 5-HT3 receptor antagonists
For chemotherapy, the drug should follow a specific schedule, and not be administered as needed
Drug is not recommended in PONV if expectation for nausea or vomiting is very small; use only if the expectation is low or it is essential to avoid nausea and vomiting in the postoperative period
Pregnancy and Lactation
There are no available data on palonosetron HCl use in pregnant women to inform a drug-associated risk
There are no data on presence in human milk, effects on breastfed infant, or on milk production
Maximum Dosage
0.25 mg IV or 0.5 mg PO as a single dose.
0.25 mg IV or 0.5 mg PO as a single dose.
20 mcg/kg/dose IV (Max: 1.5 mg/dose).
20 mcg/kg/dose IV (Max: 1.5 mg/dose).
20 mcg/kg/dose IV.
Safety and efficacy have not been established.
How supplied
Palonosetron hydrochloride
injectable solution: single-use vials
- 0.05mg/mL
