Dolasetron

Dolasetron Brand Name– Anzemet

What is Dolasetron

Dolasetron is an oral and intravenous antiemetic agent. The oral tablets are indicated for the prevention of chemotherapy-induced nausea/vomiting (CINV); the injection is only indicated for the prevention and treatment of post-operative nausea/vomiting (PONV).

Most of the activity of dolasetron is due to the active metabolite, hydrodolasetron, which is 50-fold more potent than dolasetron.

The efficacy of dolasetron is comparable to other 5-HT₃ antiemetics such as granisetron and ondansetron.

However, dolasetron has been associated with dose-dependent cardiovascular safety concerns such as QT, PR, and QRS interval prolongation and torsade de pointes; the injection is contraindicated for CINV prophylaxis as the dose and drug exposure are higher than for other uses.

Final FDA approval was granted October 6, 1997.

Indications

1. chemotherapy-induced nausea/vomiting prophylaxis
2. post-operative nausea/vomiting (PONV)
3. post-operative nausea/vomiting (PONV) prophylaxis

For chemotherapy-induced nausea/vomiting prophylaxis (CINV prophylaxis)

Side Effects

1. abdominal pain
2. agitation
3. anaphylactoid reactions
4. anemia
5. angioedema
6. anorexia
7. anxiety
8. arthralgia
9. ataxia
10. atrial fibrillation
11. atrial flutter
12. AV block
13. bradycardia
14. bronchospasm
15. bundle-branch block
16. cardiac arrest
17. chest pain (unspecified)
18. chills
19. confusion
20. constipation
21. diarrhea
22. dizziness
23. dysgeusia
24. dyspepsia
25. dyspnea
26. dysuria
27. edema
28. elevated hepatic enzymes
29. epistaxis
30. fatigue
31. fever
32. flushing
33. headache
34. hematoma
35. hematuria
36. hyperbilirubinemia
37. hyperhidrosis
38. hypotension
39. injection site reaction
40. myalgia
41. oliguria
42. orthostatic hypotension
43. palpitations
44. pancreatitis
45. paresthesias
46. peripheral edema
47. phlebitis
48. photophobia
49. polyuria
50. PR prolongation
51. prolonged bleeding time
52. purpura
53. QT prolongation
54. rash
55. renal failure (unspecified)
56. serotonin syndrome
57. shivering
58. sinus tachycardia
59. ST-T wave changes
60. syncope
61. thrombocytopenia
62. tinnitus
63. torsade de pointes
64. tremor
65. urticaria
66. ventricular fibrillation
67. ventricular tachycardia
68. vertigo

Monitoring Parameters

• ECG
• serum electrolytes

Contraindications

• apheresis
• atrial fibrillation
• AV block
• bradycardia
• breast-feeding
• cardiomyopathy
• celiac disease
• children
• dolasetron hypersensitivity
• females
• fever
• geriatric
• granisetron hypersensitivity
• heart failure
• human immunodeficiency virus (HIV) infection
• hyperparathyroidism
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypothermia
• hypothyroidism
• infants
• long QT syndrome
• myocardial infarction
• nausea/vomiting
• neonates
• ondansetron hypersensitivity
• palonosetron hypersensitivity
• pheochromocytoma
• pregnancy
• QT prolongation
• renal impairment
• rheumatoid arthritis
• sick sinus syndrome
• sickle cell disease
• sleep deprivation
• stroke
• systemic lupus erythematosus (SLE)

Interactions

• Abarelix
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Codeine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Tramadol
• Alfentanil
• Alfuzosin
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• Amitriptyline
• Amitriptyline; Chlordiazepoxide
• Amlodipine; Celecoxib
• Amoxicillin; Clarithromycin; Lansoprazole
• Amoxicillin; Clarithromycin; Omeprazole
• Anagrelide
• Apomorphine
• Aprepitant, Fosaprepitant
• Aripiprazole
• Arsenic Trioxide
• Artemether; Lumefantrine
• Asenapine
• Aspirin, ASA; Butalbital; Caffeine; Codeine
• Aspirin, ASA; Caffeine; Dihydrocodeine
• Aspirin, ASA; Carisoprodol; Codeine
• Aspirin, ASA; Oxycodone
• Atazanavir; Cobicistat
• Atenolol
• Atenolol; Chlorthalidone
• Atomoxetine
• Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Azithromycin
• Bedaquiline
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• Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
• Bepridil
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• Bismuth Subsalicylate; Metronidazole; Tetracycline
• Boceprevir
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• Brompheniramine; Hydrocodone; Pseudoephedrine
• Bumetanide
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• Carbinoxamine; Hydrocodone; Phenylephrine
• Carbinoxamine; Hydrocodone; Pseudoephedrine
• Celecoxib
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• Chloroquine
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• Chlorpheniramine; Dihydrocodeine; Phenylephrine
• Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
• Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
• Chlorpheniramine; Hydrocodone
• Chlorpheniramine; Hydrocodone; Phenylephrine
• Chlorpheniramine; Hydrocodone; Pseudoephedrine
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• Hydrocodone; Pseudoephedrine
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