Patients with intestinal obstruction or ileus. Rapid inj may lead to temporary visual changes e.g. blurred vision. Patients who have or may develop prolonged QT intervals. Safety and efficacy not established in children <18 yr. Counsel patients who handle skilled tasks e.g. driving may be impaired.
Lactation: unknown, discontinue drug or do not nurse
Indication
Chemotherapy-induced nausea and vomiting, Postoperative nausea and vomiting
Contra Indication
History of hypersensitivity.
Dose
N/A
Side Effect
1-10%
Prolonged QT interval (up to 5% ),Anxiety,Dizziness,Headache,Weakness,Constipation,Diarrhea,Prutitus,Hyperkalemia,LFT's increased
<1%
First degree atrioventricular block,Second degree atrioventricular block
Frequency Not Defined
Immune hypersensitivity reaction (very rare),Seizure
Pregnancy Category
Name :
B
Description
Animal reproduction studies have failed to demonstrate a risk to the fetus and there are no adequate and well-controlled studies in pregnant women OR Animal studies have shown an adverse effect, but adequate and well-controlled studies in pregnant women have failed to demonstrate a risk to the fetus in any trimester.
Mode of Action
Palonosetron is a selective 5-HT3 antagonist that is used in the prevention of acute and delayed emesis in emetogenic cancer chemotherapy regimens.
Interaction
May have additive effect on prolonging QT with drugs e.g. moxifloxacin, erythromycin, antipsychotics and TCAs.
Pregnancy Category Note
Pregnancy Category: B
Lactation: unknown, discontinue drug or do not nurse
Adult Dose
Prevention of Chemotherapy-induced Nausea & Vomiting
Intravenous
Adult: 0.25 mg IV as a single dose. To be given over 30 sec and 30 minutes before chemotherapy. Do not repeat within 7 days.
Oral
Alternatively 0.5 mg tablet/capsule approximately 1 hour before the start of chemotherapy. Then 0.5 mg tablet once daily.
Prevention of Postoperative Nausea & Vomiting
Adult: 0.075 mg IV as a single dose immediately before induction of anaesthesia.
Hepatic impairment: Dose adjustment not necessary
Child Dose
Prevention of Postoperative Nausea & Vomiting
<18 years: Safety and efficacy not established
Prevention of Chemotherapy-induced Nausea & Vomiting
<1 month: Safety and efficacy not established
1 month to 17 years: 20 mcg/kg IV infused over 15 minutes x1, beginning 30 minutes before chemotherapy; not to exceed 1.5 mg/dose
Renal Dose
Renal impairment: Dose adjustment not necessary
Administration
Reconstitution: Physically and chemically stable at concentrations of 5 and 30 mcg/ml in glucose 5%, sodium chloride 0.9%, glucose 5% in lactated Ringer's for at least 48 hr at room temperature, exposed to light and for 14 days under refridgeration.
IV Administration
Flush IV line with NS before and after administration
CINV: give IVP evenly over 30 sec (adults) or 15 min (children)
PONV: IVP over 10 sec
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