Description and Brand Names

Drug information provided by: Merative, Micromedex®

US Brand Name

1. Aloxi
2. Posfrea

Descriptions

Palonosetron injection is used to prevent nausea and vomiting that is caused by cancer medicines (chemotherapy). It is also used to prevent nausea and vomiting for up to 24 hours that may occur after surgery. Palonosetron works by blocking the signals to the brain that cause nausea and vomiting.

This medicine is to be given only by or under the direct supervision of your doctor.

This product is available in the following dosage forms:

• Solution

Before Using

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of Aloxi® to prevent nausea and vomiting that is caused by cancer medicines in children. However, safety and efficacy have not been established in children younger than 1 month of age.

Appropriate studies have not been performed on the relationship of age to the effects of Posfrea™ to prevent nausea and vomiting that may occur after surgery in children. Safety and efficacy have not been established. Use of Posfrea™ to prevent nausea and vomiting that is caused by cancer medicines is not indicated for use in children.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of palonosetron injection in the elderly. However, elderly patients are more sensitive to the effects of this medicine than younger adults.

Breastfeeding

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Drug Interactions

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Apomorphine

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alfentanil
• Almotriptan
• Amineptine
• Amitriptyline
• Amitriptylinoxide
• Amoxapine
• Amphetamine
• Benzhydrocodone
• Benzphetamine
• Brompheniramine
• Buprenorphine
• Buspirone
• Butorphanol
• Carbamazepine
• Chlorpheniramine
• Citalopram
• Clomipramine
• Cocaine
• Codeine
• Cyclobenzaprine
• Desipramine
• Desvenlafaxine
• Dextroamphetamine
• Dextromethorphan
• Dibenzepin
• Dihydrocodeine
• Doxepin
• Duloxetine
• Eletriptan
• Escitalopram
• Fenfluramine
• Fentanyl
• Fluoxetine
• Fluvoxamine
• Frovatriptan
• Furazolidone
• Gepirone
• Granisetron
• Hydrocodone
• Hydromorphone
• Hydroxyamphetamine
• Hydroxytryptophan
• Imipramine
• Iproniazid
• Isocarboxazid
• Lasmiditan
• Levomilnacipran
• Levorphanol
• Linezolid
• Lisdexamfetamine
• Lithium
• Lofepramine
• Lorcaserin
• Melitracen
• Meperidine
• Metaxalone
• Methadone
• Methamphetamine
• Methylene Blue
• Milnacipran
• Mirtazapine
• Moclobemide
• Morphine
• Morphine Sulfate Liposome
• Nalbuphine
• Naratriptan
• Nefazodone
• Nialamide
• Nortriptyline
• Oliceridine
• Ondansetron
• Opipramol
• Oxycodone
• Oxymorphone
• Paroxetine
• Pentazocine
• Phenelzine
• Procarbazine
• Protriptyline
• Rasagiline
• Remifentanil
• Rizatriptan
• Selegiline
• Sertraline
• Sibutramine
• St John's Wort
• Sufentanil
• Sumatriptan
• Tapentadol
• Tianeptine
• Tramadol
• Tranylcypromine
• Trazodone
• Trimipramine
• Tryptophan
• Venlafaxine
• Vilazodone
• Vortioxetine
• Zolmitriptan

Other Interactions

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Allergy to selective 5-HT3 receptor antagonists (eg, alosetron [Lotronex®], dolasetron [Anzemet®], granisetron [Kytril®], or ondansetron [Zofran®])—Use with caution. It is likely you will also be allergic to palonosetron.

Proper Use

A nurse or other trained health professional will give you or your child this medicine. This medicine is given through an IV catheter that is placed into one of your veins.

This medicine is usually given about 30 minutes before the start of chemotherapy or right before you or your child receives anesthesia (medicine to put you to sleep) for surgery.

This medicine should come with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Precautions

Check with your doctor if severe nausea and vomiting continue after leaving the hospital or cancer treatment center.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Tell your doctor right away if you or your child have chest tightness, rash, a fast heartbeat, fever, hives, itching, irritation, hoarseness, joint pain, stiffness or swelling, rash, redness of the skin, swelling of the eyelids, face, lips, hands, or feet, or trouble breathing or swallowing after receiving this medicine.

Check with your doctor right away if you have anxiety, restlessness, a fast heartbeat, fever, sweating, muscle spasms, twitching, diarrhea, or see or hear things that are not there. These may be symptoms of a serious condition called serotonin syndrome. Your risk may be higher if you also take certain other medicines that affect serotonin levels in your body.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Less common

1. Blurred vision
2. chest pain or discomfort
3. confusion
4. difficult breathing
5. dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
6. fainting
7. fever
8. slow or irregular heartbeat
9. sweating
10. unusual tiredness or weakness

Rare

1. Bleeding, blistering, burning, coldness, discoloration of the skin, feeling of pressure, hives, infection, inflammation, itching, lumps, numbness, pain, rash, redness, scarring, soreness, stinging, swelling, tenderness, tingling, ulceration, or warmth at the injection site
2. decrease in frequency of urination
3. decrease in urine volume
4. dry mouth
5. difficulty in passing urine
6. fast heartbeat
7. flushed, dry skin
8. fruit-like breath odor
9. headache
10. increased hunger
11. increased thirst
12. increased urination
13. muscle tremors
14. nervousness
15. numbness or tingling in the hands, feet, or lips
16. pain in the shoulders, arms, jaw, or neck
17. pounding in the ears
18. restlessness
19. stomach pain or cramps
20. sugar in the urine
21. unexplained weight loss
22. weakness or heaviness of legs

Incidence not known

1. Agitation
2. diarrhea
3. overactive reflexes
4. poor coordination
5. restlessness
6. shivering
7. talking or acting with excitement you cannot control
8. trembling or shaking
9. twitching

Get emergency help immediately if any of the following symptoms of overdose occur:

Symptoms of overdose

1. Bluish color of the fingernails, lips, skin, palms, or nail beds
2. collapse
3. gasping to breathe
4. paleness of the skin
5. seizures

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

1. Constipation

Less common

1. Acid or sour stomach
2. belching
3. bloated or full feeling
4. blood in the urine
5. bloody or black, tarry stools
6. burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
7. change in vision
8. chills
9. continuing ringing or buzzing
10. cough
11. deep breathing
12. diarrhea
13. drowsiness
14. dry mouth
15. excess air or gas in the stomach or intestines
16. excessive sleeping
17. eye irritation
18. fear
19. feeling happy
20. feeling of warmth
21. general feeling of discomfort or illness
22. hearing loss
23. heartburn
24. hiccups
25. impaired vision
26. indigestion
27. joint pain
28. large, flat, blue or purplish patches in the skin
29. loss of appetite
30. muscle aches and pains
31. painful knees and ankles
32. painful urination
33. passing gas
34. raised red swellings on the skin, the buttocks, legs or ankles
35. rash
36. red, sore eyes
37. redness of the face, neck, arms, and occasionally, upper chest
38. runny nose
39. sore throat
40. stomach discomfort or upset
41. swelling or protruding veins
42. trouble sleeping
43. unexplained noise in the ears
44. unusually deep sleep
45. unusually long duration of sleep
46. vein discoloration

Rare

1. Blistering, crusting, irritation, itching, or reddening of the skin
2. cracked, dry, scaly skin
3. difficulty in moving
4. muscle stiffness
5. swelling

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

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

Portions of this document last updated: Sept. 01, 2024

Original article: https://www.mayoclinic.org/es/drugs-supplements/palonosetron-intravenous-route/side-effects/drg-20065261