Palonosetron

Palonosetron is a prescription medication used to prevent nausea and vomiting caused by certain cancer treatments or surgery.  Palonosetron belongs to a group of drugs called 5-HT3 receptor antagonists, which block a natural substance called serotonin from causing nausea and vomiting.

This medication comes in an injectable form and is given into your vein (IV) by a healthcare professional.

Common side effects include headache and constipation. 

Palonosetron is a prescription medicine used to prevent nausea and vomiting that happens with certain cancer treatments (chemotherapy) or surgery in adults.

This medication may be prescribed for other uses. Ask your doctor or pharmacist for more information.

Palonosetron may be found in some form under the following brand names:

• Akynzeo

• Aloxi

Serious side effects have been reported with palonosetron. See “Drug Precautions” section.

The most common side effects of palonosetron are:

• headache
• constipation
• diarrhea
• dizziness
• tiredness (fatigue)
• stomach pain
• insomnia (trouble falling asleep or staying asleep)

Tell your doctor if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of palonosetron. For more information, ask your doctor or pharmacist.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Tell your doctor about all the medicines you take including prescription and non-prescription medicines, vitamins, and herbal supplements. While palonosetron is unlikely to interact with other medicines and no interactions have been identified, not all drug interactions are known and reported and new interactions are continually being discovered.

Serious allergic reactions. Serious allergic reactions can happen with palonosetron. Tell your doctor if you experience redness or swelling of the skin, itching, chest discomfort or shortness of breath.

Medications can interact with certain foods. In some cases, this may be harmful and your doctor may advise you to avoid certain foods. In the case of palonosetron, there are no specific foods that you must exclude from your diet when receiving this medication.

Tell your doctor about all of your medical conditions, including if you:

• have had an allergic reaction to another medicine for nausea or vomiting, such as Kytril (granisetron), Anzemet (dolasetron), Zofran (ondansetron), or to the medicine Lotronex (alosetron).
• are pregnant or plan to become pregnant. It is not known if palonosetron may harm your unborn baby. 
• are breastfeeding or plan to breastfeed. It is not known if palonosetron passes into your milk. You and your doctor should decide if you will take palonosetron or breastfeed. You should not do both.

Tell your doctor about all of the medicines you take including prescription and nonprescription medicines, vitamins and herbal supplements.

Tell your doctor if you are pregnant or plan to become pregnant.

The FDA categorizes medications based on safety for use during pregnancy. Five categories - A, B, C, D, and X, are used to classify the possible risks to an unborn baby when a medication is taken during pregnancy.

Palonosetron falls into category B. There are no good studies that have been done in humans with palonosetron. But in animal studies, pregnant animals were given this medication, and the babies did not show any medical issues related to this medication.

Tell your doctor if you are breastfeeding or plan to breastfeed. 

It is not known if palonosetron crosses into human milk. Because many medications can cross into human milk and because of the possibility for serious adverse reactions in nursing infants with use of this medication, a choice should be made whether to stop nursing or stop the use of this medication. Your doctor and you will decide if the benefits outweigh the risk of using palonosetron.

Palonosetron is given in your vein by I.V. (intravenous) injection. It is only given to you by a healthcare provider in a hospital or clinic. Palonosetron is usually injected into your vein about 30 minutes before you get your anti-cancer medicine (chemotherapy) or immediately before anesthesia for surgery.

Surgery

The recommended intravenous (IV) palonosetron dose to prevent nausea and vomiting related to surgery is 0.075 mg. It is given directly into a vein just before surgery.

Chemotherapy

The recommended intravenous (IV) palonosetron dose is 0.25 mg. It is given 30 minutes before starting chemotherapy.

The injectable form of palonosetron is usually administered by a healthcare provider in a medical setting making it unlikely for an overdose to occur. However, if overdose is suspected, seek emergency medical attention.