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a selective serotonin receptor antagonist, used as the mesylate salt for the prevention of nausea and vomiting associated with chemotherapy or occurring after surgery; administered orally and intravenously.
Pregnancy Category: B
Pharmacologic: five ht3 antagonists
Pharmacologic: five ht3 antagonists
Oral: Prevention of nausea and vomiting associated with emetogenic chemotherapy. Intravenous: Prevention and treatment of postoperative nausea/vomiting.
Blocks the effects of serotonin at receptor sites (selective antagonist) located in vagal nerve terminals and in the chemoreceptor trigger zone in the CNS.
Decreased incidence and severity of nausea/vomiting associated with emetogenic chemotherapy or surgery.
Absorption: Well absorbed but rapidly metabolized to hydrodolasetron, the active metabolite.
Metabolism and Excretion: 61% of hydrodolasetron is excreted unchanged by the kidneys.
Half-life: Hydrodolasetron—8.1 hr (shorter in children).
Time/action profile (antiemetic effect)
|PO||unknown||1–2 hr||up to 24 hr|
|IV||unknown||15–30 min||up to 24 hr|
Contraindicated in: Hypersensitivity;Prevention of nausea and vomiting associated with emetogenic chemotherapy (for IV only) (may ↑ risk of QT interval prolongation);Congenital long QT syndrome;Complete heart block (unless pacemaker present).
Use Cautiously in: Patients with risk factors for cardiac conduction abnormalities (underlying structural heart disease, sick sinus syndrome, atrial fibrillation and slow ventricular rate, myocardial ischemia, concurrent beta-blocker, verapamil, diltiazem, or antiarrhythmic therapy);Hypokalemia, hypomagenesemia, concurrent therapy with diuretics, or history of cumulative high-dose anthracycline therapy; Geriatric: ↑ risk for cardiac conduction abnormalities; Obstetric / Lactation: Safety not established.
Adverse Reactions/Side Effects
Central nervous system
- headache (increased in cancer patients)
- cardiac arrest (life-threatening)
- torsade de pointes (life-threatening)
- ventricular arrhythmias (life-threatening)
- heart block
- PR interval prolongation
- QRS interval prolongation
- QT interval prolongation
Drug-Drug interactionConcurrent diuretic or antiarrhythmic therapy or cumulative high-dose anthracycline therapy may ↑ risk of conduction abnormalities.Blood levels and effects of hydrodolasteron are ↑ by atenolol and cimetidine.Blood levels and effects of hydrodolasetron are ↓ by rifampin.↑ risk of QT interval prolongation with other agents causing QT interval prolongation.
Route/DosagePrevention of Chemotherapy-Induced Nausea/Vomiting
Oral (Adults) 100 mg given within 1 hr before chemotherapy.
Oral (Children 2–16 yr) 1.8 mg/kg given within 1 hr before chemotherapy (not to exceed 100 mg).Prevention/Treatment of Postoperative Nausea/Vomiting
Intravenous (Adults) Prevention or treatment—12.5 mg given 15 min before cessation of anesthesia (prevention) or as soon as nausea or vomiting begins (treatment).
Intravenous (Children 2–16 yr) Prevention or treatment—0.35 mg/kg (up to 12.5 mg) given 15 min before cessation of anesthesia (prevention) or as soon as nausea or vomiting begins (treatment).
Tablets: 50 mg, 100 mg
Injection: 12.5 mg/0.625 mL (in single-use vials and Carpujects), 20 mg/mL
- Assess patient for nausea, vomiting, abdominal distention, and bowel sounds before and after administration.
- Monitor vital signs after administration. IV administration may be followed by severe hypotension, bradycardia, and syncope.
- Monitor ECG in patients with HF, bradycardia, underlying heart disease, renal impairment, and elderly patients.
- Lab Test Considerations: Monitor serum potassium and magnesium prior to and periodically during therapy.
Potential Nursing DiagnosesImbalanced nutrition: less than body requirements (Indications)
- Do not confuse Anzemet with Avandamet.
- Oral: Administer within 1 hr before chemotherapy.
- Injectable dolasetron may be mixed in apple or apple-grape juice for oral dosing for pediatric patients. Recommended oral dose in patients 2 to 16 yr of age is 1.2 mg/kg (maximum 100 mg) given within 2 hr before surgery. The diluted product may be kept up to 2 hr at room temperature before use. May be stored at room temperature for 2 hr before use.
- Correct hypokalemia and hypomagnesemia before administering.
- Intravenous: Administer 15 min before cessation of anesthesia, or postoperatively if nausea and vomiting occur shortly after surgery.
- Diluent: May be administered undiluted.Concentration: 20 mg/mL.
- Rate: Administer 100 mg over at least 30 sec.
- Intermittent Infusion: Diluent: May be diluted in 50 mL of 0.9% NaCl, D5W, dextrose/saline combinations, D5/LR, LR, or 10% mannitol solution. Solution is clear and colorless. Stable for 24 hr at room temperature or 48 hr if refrigerated after dilution.
- Rate: Administer each dose as an IV infusion over up to 15 min.
- Y-Site Compatibility: acetaminophen, alfentanil, amifostine, amikacin, amiodarone, anidulafungin, argatroban, aztreonam, bivalirudin, bleomycin, bumetanide, buprenorphine, busulfan, butorphanol, calcium chloride, calcium gluconate, carboplatin, carmustine, caspofungin, ceftazidime, chlorpromazine, ciprofloxacin, cisplatin, clindamycin, cyclophosphamide, cyclosporine, cytarabine, daptomycin, dacarbazine, dactinomycin, daptomycin, daunorubicin, dexmedetomidine, dexrazoxane, diltiazem, diphenhydramine, dobutamine, docetaxel, dopamine, doxacurium, doxorubicin hydrochloride, doxycycline, enalaprilat, ephedrine, epinephrine, epirubicin, epfitibatide, ertapenem, erythromycin, esmolol, etoposide, etoposide phosphate, famotidine, fenoldopam, fentanyl, fluconazole, fludarabine, gemcitabine, gentamicin, haloperidol, hetastarch, hydromorphone, idarubicin, ifosfamide, imipenem/cilastatin, irinotecan, isoproterenol, leucovorin caclium, levofloxacin, levorphanol, lidocaine, linezolid, lorazepam, magnesium sulfate, mannitol, mechlorethamine, meperidine, mesna, methotrexate, metoclopramide, metronidazole, midazolam, milrinone, mitomycin, mitoxantrone, morphine, moxifloxacin, mycophenolate, nalbuphine, naloxone, nesiritide, nicardipine, nitroglycerin, nitroprusside, octreotide, oxaliplatin, oxytocin, paclitaxel, pamidronate, pancuronium, pemetrexed, pentamidine, phenylephrine, potassium acetate, potassium chloride, procainamide, prochlorperazine, promethazine, propranolol, quinupristin/dalfopristin, ranitidine, rocuronium, sodium acetate, streptzocin, sufentanil, tacrolimus, teniposide, theophylline, thiopental, thiotepa, tigecycline, tirofiban, tobramycin, vancomycin, vecuronium, verapamil, vinblastine, vincristine, vinorelbine, voriconazole, zidovudine, zoledronic acid
- Y-Site Incompatibility: Manufacturer recommends not admixing with other medicationsacyclovir, alemtuzumab, aminocaproic acid, aminiphylline, amphotericin B colloidal, amphotericin B lipid complex, amphotericin B liposome, pantoprazole
- Advise patient to notify health care professional if nausea or vomiting occurs.
- Advise patient to notify health care professional symptoms of abnormal heart rate or rhythm (racing heart beat, shortness of breath, dizziness, fainting) occur.
- Prevention of nausea and vomiting associated with emetogenic cancer chemotherapy.
- Prevention and treatment of postoperative nausea and vomiting.