palonosetron hydrochloride

palonosetron hydrochloride


Pharmacologic class: Selective serotonin subtype 3 (5-HT3) receptor antagonist

Therapeutic class: Antiemetic

Pregnancy risk category B


Selectively binds to and antagonizes 5-HT3 receptors on vagal nerve terminals and in chemoreceptor trigger zone. This action blocks serotonin release, reducing the vomiting reflex.


Solution for injection: 0.25 mg (free base) in 5-ml single-use vial

Indications and dosages

To prevent nausea and vomiting caused by cancer chemotherapy

Adults: 0.25 mg I.V. as a single dose 30 minutes before chemotherapy. Repeated doses within 7 days aren't recommended.

To prevent postoperative nausea and vomiting

Adults: 0.075 mg I.V. as a single dose given over 10 seconds immediately before anesthesia induction


• Hypersensitivity to drug or its components


Use cautiously in:

• hypersensitivity to other 5-HT3 receptor antagonists

• diabetes mellitus, hepatic dysfunction

• pregnant or breastfeeding patients

• children.


• Flush I.V. line with normal saline solution before and after giving.

• Deliver into I.V. line over 30 seconds. Don't mix with other drugs.

Adverse reactions

CNS: headache, fatigue, insomnia, dizziness, anxiety

CV: hypotension, vein discoloration and distention, nonsustained tachycardia, bradycardia

GI: constipation, diarrhea, abdominal pain, anorexia

GU: glycosuria

Metabolic: fluctuating electrolyte levels, hyperglycemia, metabolic acidosis, hyperkalemia

Musculoskeletal: joint pain

Other: fever, flulike symptoms


Drug-diagnostic tests: Alanine aminotransferase, aspartate aminotransferase, bilirubin, blood and urine glucose, potassium: increased levels

Patient monitoring

• Monitor vital signs and ECG. Watch closely for tachycardia, bradycardia, and hypotension.

• Watch electrolyte levels for fluctuations (especially hyperkalemia and metabolic acidosis).

• Evaluate temperature. Stay alert for flulike symptoms.

• Closely monitor blood and urine glucose levels in diabetic patients. Stay alert for hyperglycemia.

Patient teaching

• Explain that drug helps prevent nausea and vomiting caused by chemotherapy.

• Teach patient to recognize and report signs and symptoms of hyperkalemia and metabolic acidosis.

• Advise patient to report flulike symptoms.

• Instruct diabetic patient to closely watch blood and urine glucose levels.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the tests mentioned above.

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Reddy's is allowed to launch a generic version of palonosetron hydrochloride via an ANDA prior to September 30, 2018, except under certain circumstances.