Palonosetron
Mechanism :
Palonosetron is a selective 5-HT3 receptor antagonist, acting both peripherally and centrally.
Indication :
- To prevent chemotherapy induced nausea and vomiting
Contraindications :
Known hypersensitivity to palonosetron or any component of the formulation.
Dosing :
>1 month:
20 mcg/kg IV infusion over 15 minutes, starting half hour before chemotherapy. Max: 1.5 mg/dose.
Adverse Effect :
Prolonged QT interval, constipation, diarrhea, confusion, headache, blurred vision, anxiety, dizziness, faintness, or light-headedness, weakness, chest pain or discomfort, irregular heartbeats, shortness of breath, sweating, tiredness or weakness, pruritis, hyperkalemia, increased LFT.
Interaction :
Serotonin Modulators: Antiemetics (5HT3 Antagonists) may enhance the serotonergic effect of Serotonin Modulators resulting in serotonin syndrome.
Tramadol: Antiemetics (5HT3 Antagonists) may diminish the analgesic effect of Tramadol.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in normal renal function |
| HD | Unlikely to be dialysed. Dose as in normal renal function |
| HDF/High flux | Unknown dialysability. Dose as in normal renal function |
| CAV/VVHD | Unlikely to be dialysed. Dose as in normal renal function |
Hepatic Dose :
No dosage adjustments are recommended.