Palonosetron Brand Name– Aloxi
What is Palonosetron
Palonosetron is a highly selective 5-HT3 receptor antagonist indicated for the prevention of acute chemotherapy-induced nausea and vomiting (CINV) associated with initial and repeat courses of moderately or highly emetogenic chemotherapy and for the prevention of delayed emesis following moderately emetogenic chemotherapy.
Palonosetron is also used for the prevention of post-operative nausea and vomiting (PONV).
Palonosetron (Aloxi) is available in a parenteral formulation and as an oral capsule.
Palonosetron has a long half-life (roughly 40 hours) which enhances efficacy in the treatment of delayed-CINV and allows for one-time dosing within a 7-day period.
Palonosetron’s superior efficacy in controlling delayed emesis has been demonstrated against both ondansetron and dolasetron.
However, the superiority of palonosetron in acute-CINV, as compared to ondansetron or dolasetron, has not been consistently determined.
Results from two pivotal phase III clinical trials for the prevention of PONV have demonstrated the safety and efficacy of palonosetron in producing a complete response (no emesis or use of rescue medication) for a 24-hour time period following surgery.
In July 2003, palonosetron received FDA approval for use in CINV. In February 2008, palonosetron received FDA approval for the prevention of PONV for up to 24 hours after surgery.
In August 2008, palonosetron capsules received FDA approval for the prevention of acute CINV. Palonosetron injection was FDA-approved for the prevention of acute CINV in pediatric patients >= 1 month in May 2014
Indications
- chemotherapy-induced nausea/vomiting prophylaxis
- post-operative nausea/vomiting (PONV) prophylaxis
For chemotherapy-induced nausea/vomiting prophylaxis (CINV prophylaxis)
for acute chemotherapy-induced nausea/vomiting (CINV) prophylaxis associated with initial and repeat courses of highly emetogenic cancer chemotherapy
Side Effects
- abdominal pain
- amblyopia
- anaphylactic shock
- anaphylactoid reactions
- anorexia
- anxiety
- arthralgia
- bradycardia
- bronchospasm
- chills
- constipation
- contact dermatitis
- diarrhea
- dizziness
- drowsiness
- dyskinesia
- dyspepsia
- dyspnea
- edema
- elevated hepatic enzymes
- erythema
- euphoria
- fatigue
- fever
- flatulence
- glycosuria
- headache
- hiccups
- hot flashes
- hyperbilirubinemia
- hyperglycemia
- hyperkalemia
- hypersalivation
- hypertension
- hypokalemia
- hypotension
- hypoventilation
- injection site reaction
- insomnia
- laryngospasm
- metabolic acidosis
- ocular irritation
- paresthesias
- pruritus
- QT prolongation
- rash
- serotonin syndrome
- sinus tachycardia
- thrombocytopenia
- tinnitus
- urinary retention
- weakness
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- breast-feeding
- dolasetron hypersensitivity
- granisetron hypersensitivity
- neonates
- ondansetron hypersensitivity
- palonosetron hypersensitivity
- pregnancy
Interactions
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Alfentanil
- Alosetron
- Apomorphine
- Aprepitant, Fosaprepitant
- Artemether; Lumefantrine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Buprenorphine
- Buprenorphine; Naloxone
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Citalopram
- Cobicistat
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Desvenlafaxine
- Dextromethorphan; Quinidine
- Dichlorphenamide
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Dronedarone
- Duloxetine
- Elbasvir; Grazoprevir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Escitalopram
- Fenfluramine
- Fentanyl
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluvoxamine
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibuprofen; Oxycodone
- Ipecac
- Isavuconazonium
- Isocarboxazid
- Lasmiditan
- Levomilnacipran
- Levorphanol
- Linezolid
- Lithium
- Meperidine
- Meperidine; Promethazine
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methylene Blue
- Milnacipran
- Mirabegron
- Mirtazapine
- Mitotane
- Monoamine oxidase inhibitors
- Morphine
- Morphine; Naltrexone
- Nalbuphine
- Oxycodone
- Oxymorphone
- Ozanimod
- Paroxetine
- Peginterferon Alfa-2b
- Phenelzine
- Quinidine
- Remifentanil
- Selegiline
- Sertraline
- Sufentanil
- Tapentadol
- Telotristat Ethyl
- Tramadol
- Tranylcypromine
- Venlafaxine
- Vilazodone