Palonosetron (Intravenous)

Overview

Palonosetron helps to prevent patients from becoming nauseous and vomiting. It is used in the treatment of patients undergoing chemotherapy and in patients who have undergone surgery that may also cause nausea or vomiting.

Palonosetron acts upon the brain to prevent signals being transmitted that will cause nausea and vomiting.

Palonosetron must only be given under the direct supervision of a doctor and is administered as an injection of Aloxi, directly into the vein of the patient.

Condition treated

• Nausea, caused by treatment
• Vomiting, caused by treatment

Type Of Medicine

• Serotonin blocker

Side Effects

In addition to the required effects of sickness and nausea prevention, Palonosetron can also have unwanted side effects on the patient. Many of these side effects can be mild, but others may require you to seek medical attention. It is also possible to overdose on this treatment and this will require emergency medical attention to be sought.

If the following symptoms of overdose are experienced, then you should seek emergency medical attention:

• Bluish coloration or paling of fingernails, palms, nail beds, lips or skin
• Collapsing
• Inability to breathe steadily or gasping for breath
• Paleness of the skin
• Seizures or convulsions

You should seek immediate medical attention from the supervising doctor if you experience any of the following side effects from use:

Occurring less commonly:

• Blurring of vision
• Chest pain
• Confusion or disorientation
• Difficulty with breathing
• Discomfort across the chest
• Dizziness, faintness or lightheadedness when rising suddenly from sitting or lying
• Fainting or faintness
• Feverishness
• Irregularity of heartbeats
• Sweating
• Unusual tiredness
• Unusual weakness

Occurring only rarely:

• Extra heartbeats
• Nervousness
• Pain occurring in the shoulders, arms, jaw or neck
• Pounding sound in the ears
• Slowed or increased heartbeat

Frequency of occurrence not known:

• Agitation
• Diarrhea
• Loss of coordination
• Overactivity of reflexes
• Restlessness
• Shaking
• Shivering or trembling
• Talking or acting with excitement that cannot be controlled
• Twitching

The following side effects can occur at the site of injection and should be reported to the supervising doctor immediately for attention.

• Warmth
• Ulceration
• Tingling
• Tenderness
• Swelling
• Stinging
• Soreness
• Scarring
• Redness
• Rash
• Pain
• Numbness
• Lumps
• Itching
• Inflammation
• Infection
• Hives
• Feeling of pressure
• Discoloration of the skin
• Coldness
• Burning
• Blistering
• Bleeding

Other side effects from the use of Palonosetron can also occur, though they would not normally require you to seek attention from a doctor. These side effects will usually abate over time and may be mild. If they are ongoing, however, or if they are particularly bothersome, then you can report them to your doctor for advice.

Occurring commonly:

• Difficulty passing a bowel movement
• Headaches

Occurring only less commonly:

• Acid stomach
• Belching or burping
• Black stools with a tarry appearance
• Bloated or feeling of fullness
• Blood appearing in the urine
• Bloody stools
• Breath odor with a fruit-like smell
• Burning, crawling, itching, prickling or tingling feelings of the skin
• Changed vision
• Chills
• Continued ringing or buzzing
• Coughing
• Decrease in frequency of need to urinate
• Decreased in volume of urine
• Deepened breathing
• Difficulty with passing of urine
• Drowsiness
• Dryness of the mouth
• Excess air or gas building up in the stomach or intestines
• Excessive sleeping
• Fear
• Feeling of happiness
• Feeling of warmth
• Flushing of dry skin
• General feeling of discomfort
• General feeling of illness
• Hearing loss
• Heartburn
• Heaviness of the legs
• Hiccups
• Impairment of vision
• Increase in urination
• Increased hunger
• Increased sugar in the urine
• Increased thirstiness
• Indigestion
• Irritation of the eye
• Joint pains
• Loss of appetite
• Muscle aches
• Muscle pains
• Muscle tremors
• Numbness or tingling experienced in the hands, feet or lips
• Pain in the ankles
• Painful knees
• Painful urination
• Passing of gas
• Patches appearing on the skin that may be large, flat and purple
• Pins and needles
• Rash
• Redness of the face, neck, arms and upper chest
• Runny nose
• Soreness of the eyes
• Soreness of the throat
• Sour stomach
• Stomach discomfort
• Stomach pain
• Stomach upset
• Swelling or protrusion of the veins
• Swellings appearing on the skin, the buttocks, legs or ankles that are raised
• Troubled sleep
• Unexplained noise in the ears
• Unexplained weight loss
• Unusual duration of sleep
• Unusually deep sleeping
• Vein discolorations
• Weakness of the legs

Other side effects could also occur that have not been listed herein. Patients should report any other side effects to their doctor. If you believe your immediate health is at risk, however, then you should always contact the emergency services.

Dosage

This medication will only ever be administered by a nurse or doctor. It will be given through a needle that is placed into a vein.

You should receive this medication roughly 30 minutes before you receive a chemotherapy treatment.

You should receive this medication immediately before receiving anesthetic for surgical procedures.

Interactions

Some medications should not be used in conjunction with one another. In some cases, severe reactions can occur when two treatments are used together. In other cases, medications may stop one another from working or may cause more severe side effects to occur from use.

You should inform your doctor of all medications that you are taking before you begin using Palonosetron to avoid the occurrence of interactions. This is particularly important in the following cases:

Use of Palonosetron is not recommended in patients who are taking the following treatment. Other medications may be found instead:

• Apomorphine

The use of Palonosetron with the following medications would not normally be recommended. If you are taking the following, then Palonosetron may still be prescribed, but doses of treatment may be adjusted or the frequency of use may be changed:

• Zolmitriptan
• Vortioxetine
• Vilazodone
• Venlafaxine
• Tryptophan
• Trimipramine
• Trazodone
• Tranylcypromine
• Tramadol
• Tianeptine
• Tapentadol
• Sumatriptan
• St John's Wort
• Sibutramine
• Sertraline
• Selegiline
• Rizatriptan
• Rasagiline
• Protriptyline
• Procarbazine
• Phenelzine
• Pentazocine
• Paroxetine
• Oxycodone
• Opipramol
• Nortriptyline
• Nialamide
• Nefazodone
• Naratriptan
• Moclobemide
• Mirtazapine
• Milnacipran
• Methylene Blue
• Methadone
• Meperidine
• Melitracen
• Lorcaserin
• Lofepramine
• Lithium
• Linezolid
• Levomilnacipran
• Isocarboxazid
• Iproniazid
• Imipramine
• Hydroxytryptophan
• Furazolidone
• Frovatriptan
• Fluvoxamine
• Fluoxetine
• Fentanyl
• Escitalopram
• Eletriptan
• Duloxetine
• Doxepin
• Dibenzepin
• Dextromethorphan
• Desvenlafaxine
• Desipramine
• Cyclobenzaprine
• Cocaine
• Clomipramine
• Citalopram
• Chlorpheniramine
• Carbamazepine
• Buspirone
• Buprenorphine
• Brompheniramine
• Amoxapine
• Amitriptylinoxide
• Amitriptyline
• Amineptine
• Almotriptan

Other interactions that have not been listed can also occur. Ensure that your doctor is aware of all medications, including prescription and non-prescription or over the counter medications and herbal and vitamin supplements, that you are taking, so that you can avoid interactions where possible.

Certain medical conditions can also prevent the use of some medications. This is because conditions can be worsened by use and because some conditions may cause or increase the side effects experienced. You should inform your doctor of all medical conditions from which you suffer and from which you have suffered in the past before you are administered Palonosetron.

Warnings

Before using any medication, you should consider the benefits of use in relation to the risks of use. For Palonosetron, you should ensure that you have considered all of the following with your doctor in making this decision:

Allergies

You should inform your doctor of any allergic reactions that you have suffered from in the past. Allergies to medications in particular are important and may prohibit use.

Pediatric

There are no known limitations to the use of Palonosetron in the treatment of children over the age of one when used to prevent nausea and vomiting during chemotherapy. Safety and efficiency below the age of one has not been established.

Safety and efficiency of use in children has not been established for use to prevent nausea and vomiting following surgery.

Geriatric

There are no known limitations for use in elderly patients.

Pregnancy

You must inform your doctor if you are pregnant before taking this drug. There is a minimal risk during pregnancy, but both surgery and chemotherapy may put the child at risk. Ensure your doctor is fully aware if you are pregnant in any trimester.

Breastfeeding

The risk of breastfeeding during the use of this medication is not known. You should discuss this with your doctor and make a decision having weighed the risks against the benefits.

If you experience severe nausea after leaving the center, then you must inform your doctor.

You may suffer from sever allergic reactions from the use of this medication. Anaphylaxis, which is a life-threatening allergic reaction, can occur and will need immediate medical attention. If you are not at the hospital when this occurs, then you should call the emergency services. The following symptoms may indicate that you are experiencing anaphylaxis:

• Rash
• Increased heartrate
• Feverishness
• Hives
• Itching
• Irritation
• Swelling
• Stiffness
• Redness of the skin
• Swollen eyelid, face or lips
• Swollen hands or feet
• Tightness of the chest
• Troubled breathing
• Trouble with swallowing

Palonosetron can cause serotonin syndrome, which is a very serious condition, if it is taken with particular medications. You should not take medications to treat depression or certain other medications, such as tramadol or lithium, with Palonosetron. Do not take any other medications in conjunction with this treatment unless they have been ordered for use by your doctor.

Storage

This medication should be kept at room temperature and does not require special storage conditions to be followed.

The medication is supplied in packs of one vial for single use and each vial will contain 5ml of solution. One vial should be used only for the treatment of one patient.

Summary

Palonosetron is an injected medication used to reduce vomiting and nausea. It is used for patients who are receiving chemotherapy treatment and for patients undergoing surgery.

In patients receiving chemotherapy, this medication should be given 30 minutes before the patient begins chemotherapy. Use in children over the age of one has been approved for safety and efficiency in this case.

In patients undergoing surgery, this medication should be given immediately before the anesthetic is administered. Use in children for surgery has not been tested for safety and efficiency.

Palonosetron should only ever be administered under the direct supervision of a doctor in a hospital environment. The medication can cause a range of unwanted side effects that will need to be treated immediately if they occur and you will need to be monitored following administration of the treatment.

Sever allergic reactions to this medication can occur. You should inform your doctor of all allergies before you are given treatment.

Do not take any other medications at the same time as this treatment unless they have been approved for use by your doctor.