Generic Name

Palonosetron

Precaution

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

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