Palonosetron

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Generic Name: Palonosetron Brand Name(s): Generics only. No brands available.

Uses

What is Palonosetron used for?

Palonosetron is used to prevent nausea and vomiting caused by cancer drug treatment (chemotherapy). It is also used to prevent nausea and vomiting after surgery. Palonosetron works by blocking one of the body’s natural substances (serotonin) that causes vomiting.

How should I take Palonosetron?

This medication is given by injection into a vein by a health care professional. It is given as directed by your doctor, usually 30 minutes before the start of chemotherapy or right before the start of surgery.

The dosage is based on your medical condition and response to treatment. In children, the dosage is also based on weight.

Tell your doctor if you vomit or feel nauseated.

How do I store Palonosetron?

  • Store at 20° to 25°C (68° to 77°F); [Excursions permitted to 15° to 30°C (59° to 86°F)].
  • Protect from freezing.
  • Protect from light.

If you need to store palonosetron at home, talk with your doctor, nurse, or pharmacist about how to store it.

There may be different brands of Palonosetron that may have different storage needs. It is important to always check the product package for instructions on storage, or ask your pharmacist. For safety, you should keep all medicines away from children and pets.

You should not flush Palonosetron down the toilet or pour them into a drain unless instructed to do so. It is important to properly discard this product when it is expired or no longer needed. Consult your pharmacist for more details about how to safely discard your product.

Precautions & warnings

What should I know before using Palonosetron?

Before using palonosetron, tell your doctor or pharmacist if you are allergic to it; or to other anti-nausea serotonin blockers (such as ondansetron, granisetron); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history.

Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.

Is it safe during pregnancy or breast-feeding?

There are no adequate studies in women for determining risk when using this Palonosetron during pregnancy or while breastfeeding. Please always consult with your doctor to weigh the potential benefits and risks before taking Palonosetron. Palonosetron is pregnancy risk category B according to the US Food and Drug Administration (FDA).

FDA pregnancy risk category reference below:

  • A=No risk,
  • B=No risk in some studies,
  • C=There may be some risk,
  • D=Positive evidence of risk,
  • X=Contraindicated,
  • N=Unknown

Side effects

What side effects can occur from Palonosetron?

Pain, redness, or swelling at the injection site may occur. Headache, constipation, or diarrhea may also occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

Not everyone experiences these side effects. There may be some side effects not listed above. If you have any concerns about a side-effect, please consult your doctor or pharmacist.

Interactions

What drugs may interact with Palonosetron?

The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/”ecstasy,” St. John’s wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.

Palonosetron may interact with other drugs that you are currently taking, which can change how your drug works or increase your risk for serious side effects. To avoid any potential drug interactions, you should keep a list of all the drugs you are using (including prescription drugs, nonprescription drugs and herbal products) and share it with your doctor and pharmacist. For your safety, do not start, stop, or change the dosage of any drugs without your doctor’s approval.

Does food or alcohol interact with Palonosetron?

Palonosetron may interact with food or alcohol by altering the way the drug works or increase the risk for serious side effects. Please discuss with your doctor or pharmacist any potential food or alcohol interactions before using this drug.

What health conditions may interact with Palonosetron?

Palonosetron may interact with your health condition. This interaction may worsen your health condition or alter the way the drug works. It is important to always let your doctor and pharmacist know all the health conditions you currently have.

Dosage

The information provided is not a substitute for any medical advice. You should ALWAYS consult with your doctor or pharmacist before using this Palonosetron.

What is the dose of Palonosetron for an adult?

Usual Adult Dose for Nausea/Vomiting – Chemotherapy Induced

Oral: 0.5 mg orally administered approximately 1 hour prior to the start of chemotherapy

Uses: Moderately emetogenic cancer chemotherapy: Prevention of acute nausea and vomiting associated with initial and repeat courses.

Parenteral: 0.25 mg IV as a single dose 30 minutes before the start of chemotherapy

Uses: Prevention of acute nausea and vomiting in adults associated with initial and repeat courses of moderately and highly emetogenic cancer chemotherapy.

Usual Adult Dose for Nausea/Vomiting – Postoperative

Parenteral: 0.075 mg IV as a single dose immediately before induction of anesthesia

Uses: Prevention of postoperative nausea and vomiting (PONV) in adults for up to 24 hours following surgery. Efficacy beyond 24 hours has not been determined.

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

No adjustment recommended

Dose Adjustments

-No dose adjustment is required in elderly patients.

-Experience with repeat dosing within a course of multi-day chemotherapy is limited.

Precautions

This drug may increase large bowel transit time; therefore, it is recommended to monitor patients with a history of constipation or signs of subacute intestinal obstruction following administration.

What is the dose of Palonosetron for a child?

Usual Pediatric Dose for Nausea/Vomiting – Chemotherapy Induced

Parenteral: 20 mcg/kg IV (maximum 1.5 mg x 1) infused over 15 minutes beginning 30 minutes before the start of chemotherapy

Uses: Prevention of acute nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including highly emetogenic cancer chemotherapy in patients 1 month to less than 17 years of age.

Precautions

Safety and effectiveness have not been established in patients younger than 18 years.

How is Palonosetron available?

Palonosetron is available in the following dosage forms and strengths:

  • Intravenous solution.

What should I do in case of an emergency or overdose?

In case of an emergency or an overdose, call your local emergency services or go to your nearest emergency room.

What should I do if I miss a dose?

If you miss a dose of Palonosetron, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and take your regular dose as scheduled. Do not take a double dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: April 11, 2018 | Last Modified: April 11, 2018

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