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
• 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.
CNS: headache, fatigue, insomnia, dizziness, anxiety
CV: hypotension, vein discoloration and distention, nonsustained tachycardia, bradycardia
GI: constipation, diarrhea, abdominal pain, anorexia
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
• 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.
• 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.