How does this medication work? What will it do for me?
Palonosetron belongs to the class of medications called 5-HT3 receptor antagonists. This medication is used to prevent nausea and vomiting associated with certain types of cancer chemotherapy. It works by reducing the effects of a naturally occurring chemical in the body called serotonin, which causes nausea and vomiting.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Injection: The recommended adult dose is 0.25 mg given as an injection into the vein (intravenous) over 30 seconds, and about 30 minutes before you get your anticancer medicine (chemotherapy).
Capsule: The recommended adult dose is 0.5 mg (one capsule) by mouth about an hour before you get your anticancer medicine (chemotherapy). Palonosetron can be taken with or without food.
Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.
This medication is stored at room temperature and the injection is also protected from light.
How should I use this medication?
Every 5 mL of clear, colourless solution in glass vials contains 0.25 mg of palonosetron (as hydrochloride). Nonmedicinal ingredients: mannitol, disodium edetate, and citrate buffer in water.
Each light beige, opaque, soft gelatin capsule, contains palonosetron (free base) 0.5 mg. Nonmedicinal ingredients: monoglycerides and diglycerides of capryl/capric acid, gelatin, sorbitol, glycerin, water, polyglyceryl oleate, titanium dioxide, butylated hydroxyanisole, and black printing ink. May contain traces of medium chain triglyceride and lecithin.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use this medication if you are allergic to palonosetron or any of the other ingredients in the injection or capsule.
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- abdominal pain
Stop taking the medication and seek immediate medical attention if any of the following occur:
- symptoms of a severe allergic reaction (such as hives, rash, difficulty breathing or swallowing, swelling of the face, lips, tongue, or throat)
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
HEALTH CANADA ADVISORY
May 15, 2014
Health Canada has issued new restrictions concerning the use of Aloxi (palonosetron). To read the full Health Canada Advisory, visit Health Canada's web site at www.hc-sc.gc.ca.
Allergy: Before you take palonosetron, inform your doctor about any previous side effects or reactions you have had to medications. Contact your doctor at once if you experience signs of an allergic reaction such as skin rash, itching, difficulty breathing, or swelling of the face and throat. If you have had an allergic reaction to ondansetron, dolasetron, or granisetron, do not take palonosetron.
Heart rhythm: Very rarely, palonosetron can affect the heart's electrical activity and cause an abnormal heart rhythm called QT prolongation. People with heart problems (e.g., an irregular heartbeat, QT prolongation) or a family history of QT prolongation or sudden cardiac death before the age of 50, should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed. If you are taking other medications that can also affect heart rhythm, inform your doctor before using palonosetron.
Kidney problems: The safety and effectiveness of using this medication have not been established for people with end-stage kidney disease.
Pregnancy: The safety of palonosetron for use by pregnant women has not been established. This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.
Breast-feeding: It is not known if palonosetron passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children under 18 years of age. Its use by this age group is not recommended.
What other drugs could interact with this medication?
Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications that you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.