PALONOSETRON
| 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