palonosetron hydrochloride

palonosetron hydrochloride

Aloxi

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

Therapeutic class: Antiemetic

Pregnancy risk category B

Action

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.

Availability

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

Contraindications

• Hypersensitivity to drug or its components

Precautions

Use cautiously in:
• hypersensitivity to other 5-HT3 receptor antagonists
• diabetes mellitus, hepatic dysfunction
• pregnant or breastfeeding patients
• children.

Administration

• 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

Interactions

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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References in periodicals archive ?
Reddy's is allowed to launch a generic version of palonosetron hydrochloride via an ANDA prior to September 30, 2018, except under certain circumstances.
In July 2003, the Food and Drug Administration approved palonosetron hydrochloride injection for the treatment of chemotherapy-induced nausea and vomiting (CINV).
75mg infusion bag formulation of palonosetron hydrochloride (Aloxi).
LUGANO, Switzerland, and DUBLIN, Ireland, September 6 /PRNewswire/ -- Helsinn Healthcare SA, a Swiss pharmaceutical group, and Cambridge Laboratories Limited, a pharmaceutical company based in the UK and Ireland, announce the signing of an agreement granting Cambridge the exclusive License and Distribution rights for PALONOSETRON HYDROCHLORIDE in the UK.
Palonosetron hydrochloride, developed for the prevention of chemotherapy-induced nausea and vomiting (CINV), is a selective 5-HT3 receptor antagonist with strong binding affinity and an extended plasma half-life of approximately 40 hours.