Generic Name:

Palonosetron Hydrochloride

Trade Name:

Aloxi

Designated Clinical Areas:

All areas

Action:

Selective 5-HT3 receptor antagonist

Indication:

•  Second-line antiemetic for patients with an oncologic diagnosis that have required highly or moderately emetogenic chemotherapy and have had inadequate response to, or who cannot receive treatment with ondansetron/corticosteroid.

•  Patient is receiving intra-peritoneal cisplatin therapy.

•  Palonosetron is NOT to be used for post-operative nausea and vomiting.

Critical Elements/

Special Considerations:

•  Palonosetron should not be used concurrently with ondansetron or other 5HT3 antagonists

•  Hypersensitivity reactions may occur in patients who have exhibited hypersensitivity to other 5-HT3 receptor antagonists.

•  Use of concomitant corticosteroid for 2-3 days following palonosetron is recommended for optimal control of delayed nausea/emesis.

•  Is typically given before chemotherapy on day 1 only (half-life 40 hours), but may also be repeated in multi-day regimens after 72 hours

Administration Guidelines:

•  Administer palonosetron undiluted

•  Administer IVP over 30 seconds; flush infusion line with NS before and after injection

Usual dose and route:

Recommended adult dose is 0.25mg in 5ml IVP 30 minutes before the start of chemotherapy

Precaution and Side Effects

•  Rare side effects include dizziness, tachycardia, bradycardia, hypotension, QT prolongation, elevated LFTs

•  Like with other 5-HT3 antagonists, use with caution in patients at risk of QT prolongation.

•  Headache

•  Constipation

Approved by:

MESAC Approval Committee 11/20/2008

MESAC 11/25/2008

Reviewed by:

Approval Committee

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