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PALONOSETRON

Medical Diagnosis and Drugs, Medications
PALONOSETRON
(pal-o-no'si-tron)
Aloxi
Classifications: 5-ht3 antagonist; antiemetic;
Therapeutic: antiemetic; serotonin 5-ht3 receptor antagonist
Prototype: Ondansetron
Pregnancy Category: B

Availability

0.25 mg/5 mL injection

Action

Selectively blocks serotonin 5-HT3 receptors found centrally in the chemoreceptor trigger zone (CTZ) of the hypothalamus, and peripherally at vagal nerve endings in the intestines.

Therapeutic Effect

Prevents acute chemotherapy-induced nausea and vomiting associated with initial and repeat courses of moderately or highly emetogenic chemotherapy.

Uses

Prevention of acute and delayed nausea and vomiting associated with highly emetogenic cancer chemotherapy.

Unlabeled Uses

Postoperative nausea/vomiting.

Contraindications

Hypersensitivity to palonosetron; lactation, children <18 y.

Cautious Use

Dehydration; cardiac arrhythmias, QT prolongation; electrolyte imbalance; pregnancy (category B).

Route & Dosage

Prevention of Chemotherapy-Induced Nausea and Vomiting
Adult: IV 0.25 mg infused over 30 sec 30 min prior to chemotherapy; do not repeat for at least 7 d

Hepatic Impairment/Renal Impairment
No adjustment necessary.

Administration

Intravenous

PREPARE: Direct: Do not dilute and do not mix with other drugs.  

ADMINISTER: Direct: Give over 30 sec. Flush IV line with NS before and after administration.  

INCOMPATIBILITIES Do not mix with other drugs.

  • Store at room temperature of 15°–30° C (59°–86° F). Protect from light.

Adverse Effects (≥1%)

CNS: Headache, anxiety, dizziness. GI: Constipation, diarrhea, abdominal pain. Dermatologic: Pruritus.

Interactions

Drug: Can cause profound hypotension with apomorphine.

Pharmacokinetics

Metabolism: In liver (CYP2D6, 1A2, 3A4). Elimination: Primarily renal. Half-Life: 40 h.

Nursing Implications

Assessment & Drug Effects

  • Monitor closely cardiac status especially in those taking diuretics or otherwise at risk for hypokalemia or hypomagnesemia, with congenital QT syndrome, or patients taking antiarrhythmic or other drugs that lead to QT prolongation.

Patient & Family Education

  • Report promptly any of the following: difficulty breathing, wheezing, or shortness of breath; palpitations or chest tightness; skin rash or itching; swelling of the face, tongue, throat, hands, or feet.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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