Palonosetron
Antiemetic & Gastroprokinetic · 5HT3-antagonist
Indications
Prevention of chemotherapy-induced nausea and vomiting. Prevention of postoperative nausea and vomiting.
Dosage
Prevention of Chemotherapy-induced nausea and vomiting: IV: Adults: 0.25 mg as a single IV dose administered over 30 seconds. Administer dose 30 mins before the initiation of chemotherapy. Children: <1 mth: Not recommended. 1 mth-18 yrs: 20 mcg/kg infused over 15 mins, beginning 30 mins before chemotherapy; not to exceed 1.5 mg/dose. Prevention of Postoperative nausea and vomiting: Adults: IV: 0.075 mg as a single IV dose administered over 10 seconds immediately before the induction of anaesthesia. Children: Not recommended.
Administration
Flush the infusion line with NS before and after administration of Palonosetron HCl injection. Inspect inj visually for particulate matter and discoloration before administration. Do not mix with other drugs. Paediatric administration: For a dose of 0.25 mg, use either the single-dose vial or pre-filled syringe. Do not use pre-filled syringe to administer a dose other than 0.25 mg.
Adverse Effects
Hyperkalaemia, metabolic disorders, hypocalcaemia, anorexia, hyperglycaemia, decreased appetite, anxiety, euphoric mood, headache, dizziness, somnolence, insomnia, paraesthesia, hypersomnia, peripheral sensory neuropathy, eye irritation, amblyopia, motion sickness, tinnitus. Tachycardia, bradycardia, extrasystoles, myocardial ischaemia, sinus tachycardia, sinus arrhythmia, supraventricular extrasystoles, hypotension, hypertension, vein discolouration, vein distended, dermatitis, pruritic rash, arthralgia, urinary retention, glycosuria, asthaenia, pyrexia, fatigue, feeling hot, influenza like illness.
Risk Factor (Pregnancy/Lactation)
Pregnancy: No evidence of risk in humans. Lactation: Caution advised or effect undetermined. Contraindications: Coadministration with apomorphine. Precautions: Congenital long QT syndrome or other factors that may prolong QT interval. For chemotherapy, the drug should follow a specific schedule, and not be administered as needed.
Interactions
Serotonergic drugs including SSRIs, SNRIs, MAO inhibitors, lithium, tramadol, methylene blue IV and mirtazapine (avoid).
Advice to Patient
Contact prescriber/nurse right away if you experience hives, swelling in face, trouble in breathing, chest pain, agitation, hallucinations, confusion, coma, fast/unusual heartbeat, dizziness, sweating, flushing, fever, tremors, stiffness in muscles, muscle twitching, loss of coordination, seizures, nausea, vomiting, diarrhoea.
Pharmacokinetics
Metabolism: Hepatic. Half-life elimination: Terminal: 40 hrs. Time to peak, plasma: 5.6±5.5 mg/mL (dose-proportional). Excretion: Urine (80-93%). Faeces (5-8%).
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
Always consult a pharmacist or doctor.