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Health Guide

Palonosetron (Intravenous route)

Pronunciation:

pal-oh-NOE-se-tron

Brand Names:

  • Aloxi

Dosage Forms:

  • Solution

Classifications:

Therapeutic—

Antiemetic

Pharmacologic—

Serotonin Receptor Antagonist, 5-HT3

Uses of This Medicine:

Palonosetron injection is used to prevent nausea and vomiting that is caused by cancer medicines (chemotherapy). It is also used to prevent nausea and vomiting that may occur after surgery. Palonosetron works by blocking the signals to the brain that cause nausea and vomiting.

This medicine is to be given only by or under the direct supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of palonosetron injection to prevent nausea and vomiting that is caused by cancer medicines in children. However, safety and efficacy have not been established in children younger than 1 month of age.

Appropriate studies have not been performed on the relationship of age to the effects of palonosetron injection to prevent nausea and vomiting that may occur after surgery in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of palonosetron injection in the elderly.

Pregnancy—

Pregnancy CategoryExplanation
All TrimestersBAnimal studies have revealed no evidence of harm to the fetus, however, there are no adequate studies in pregnant women OR animal studies have shown an adverse effect, but adequate studies in pregnant women have failed to demonstrate a risk to the fetus.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Apomorphine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Alfentanil
  • Almotriptan
  • Amineptine
  • Amitriptyline
  • Amitriptylinoxide
  • Amoxapine
  • Amphetamine
  • Benzphetamine
  • Brompheniramine
  • Buprenorphine
  • Buspirone
  • Butorphanol
  • Carbamazepine
  • Chlorpheniramine
  • Citalopram
  • Clomipramine
  • Cocaine
  • Codeine
  • Cyclobenzaprine
  • Desipramine
  • Desvenlafaxine
  • Dextroamphetamine
  • Dextromethorphan
  • Dibenzepin
  • Dihydrocodeine
  • Doxepin
  • Duloxetine
  • Eletriptan
  • Escitalopram
  • Fentanyl
  • Fluoxetine
  • Fluvoxamine
  • Frovatriptan
  • Furazolidone
  • Hydrocodone
  • Hydromorphone
  • Hydroxytryptophan
  • Imipramine
  • Iproniazid
  • Isocarboxazid
  • Levomilnacipran
  • Levorphanol
  • Linezolid
  • Lisdexamfetamine
  • Lithium
  • Lofepramine
  • Lorcaserin
  • Melitracen
  • Meperidine
  • Methadone
  • Methamphetamine
  • Methylene Blue
  • Milnacipran
  • Mirtazapine
  • Moclobemide
  • Morphine
  • Morphine Sulfate Liposome
  • Nalbuphine
  • Naratriptan
  • Nefazodone
  • Nialamide
  • Nortriptyline
  • Opipramol
  • Oxycodone
  • Oxymorphone
  • Paroxetine
  • Pentazocine
  • Phenelzine
  • Procarbazine
  • Protriptyline
  • Rasagiline
  • Remifentanil
  • Rizatriptan
  • Selegiline
  • Sertraline
  • Sibutramine
  • St John's Wort
  • Sufentanil
  • Sumatriptan
  • Tapentadol
  • Tianeptine
  • Tramadol
  • Tranylcypromine
  • Trazodone
  • Trimipramine
  • Tryptophan
  • Venlafaxine
  • Vilazodone
  • Vortioxetine
  • Zolmitriptan

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of This Medicine:

You will receive this medicine while you or your child are in a hospital or cancer treatment center. A nurse or other trained health professional will give you or your child this medicine. This medicine is given through a needle placed in one of your veins.

This medicine is usually given about 30 minutes before the start of chemotherapy or right before you or your child receives anesthetic medicine for surgery.

This medicine should come with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Precautions While Using This Medicine:

Check with your doctor if severe nausea and vomiting continue after leaving the hospital or cancer treatment center.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you or your child have a rash, a fast heartbeat, fever, hives, itching, irritation, hoarseness, joint pain, stiffness or swelling, rash, redness of the skin, swelling of the eyelids, face, lips, hands, or feet, tightness in the chest, or trouble breathing or swallowing after receiving this medicine.

Palonosetron may cause a serious condition called serotonin syndrome if taken together with some medicines such as fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), tramadol (Ultram®), or medicines to treat depression (such as mirtazapine, Remeron®). Check with your doctor first before taking any other medicines with palonosetron.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common
Blurred vision
chest pain or discomfort
confusion
difficult breathing
dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
fainting
fever
irregular heartbeats that continue
sweating
unusual tiredness or weakness
Rare
Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
extra heartbeats
nervousness
pain in the shoulders, arms, jaw, or neck
pounding in the ears
slow or fast heartbeat
Incidence not known
Agitation
diarrhea
overactive reflexes
poor coordination
restlessness
shivering
talking or acting with excitement you cannot control
trembling or shaking
twitching

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose
Bluish color of the fingernails, lips, skin, palms, or nail beds
collapse
gasping to breathe
paleness of the skin
seizures

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
Difficulty having a bowel movement (stool)
headache
Less common
Acid or sour stomach
belching
bloated or full feeling
blood in the urine
bloody or black, tarry stools
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
change in vision
chills
continuing ringing or buzzing
cough
decrease in frequency of urination
decrease in urine volume
deep breathing
difficulty in passing urine
drowsiness
dry mouth
excess air or gas in the stomach or intestines
excessive sleeping
eye irritation
fear
feeling happy
feeling of warmth
flushed dry skin
fruit-like breath odor
general feeling of discomfort or illness
hearing loss
heartburn
hiccups
impaired vision
increased hunger
increased thirst
increased urination
indigestion
joint pain
large, flat, blue or purplish patches in the skin
loss of appetite
muscle aches and pains
muscle tremors
numbness or tingling in the hands, feet, or lips
painful knees and ankles
painful urination
passing gas
raised red swellings on the skin, the buttocks, legs or ankles
rash
red, sore eyes
redness of the face, neck, arms, and occasionally, upper chest
runny nose
sore throat
stomach discomfort, upset, or pain
sugar in the urine
swelling or protruding veins
trouble sleeping
unexplained noise in the ears
unexplained weight loss
unusually deep sleep
unusually long duration of sleep
vein discoloration
weakness or heaviness of the legs

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.


Last Updated: 7/4/2017
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