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Overview: Palonosetron is an injectable medicine that is used to prevent nausea and vomiting from surgery or chemotherapy. It works by blocking receptors that can trigger nausea and vomiting in the gut and brain. Common side effects may include headache and constipation. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat. Tell your health care provider about all medicines, supplements, and herbal products that you take before receiving palonosetron.

Uses

What is palonosetron used for?

Palonosetron is commonly used to prevent nausea and vomiting that can happen when using medicines for cancer (chemotherapy) and after surgery.

Palonosetron may also be used for other conditions as determined by your health care provider.

How does palonosetron work (mechanism of action)?

Palonosetron blocks a specific receptor in the gut (intestines) and brain called 5-HT3 that normally causes nausea and vomiting when your body is exposed to certain substances, such as chemotherapy or anesthesia, or after surgery (especially on the gut). By blocking this receptor, palonosetron reduces nausea and vomiting caused by chemotherapy or surgery/anesthesia.

How is palonosetron supplied (dosage forms)?

Brands and other names

  • Aloxi
  • Posfrea

Dosage forms and strengths

  • Palonosetron is available as an injectable solution that is given by a health care provider.

How should I store palonosetron?

Palonosetron is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of palonosetron?

The most common side effects of palonosetron are listed below. These side effects may vary depending on the reason you are using palonosetron. Tell your health care provider if you have any of these side effects that bother you.

  • Headache
  • Constipation
  • Slow heartbeat

There may be other side effects of palonosetron that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of palonosetron?

While less common, the most serious side effects of palonosetron are described below, along with what to do if they happen.

Severe Allergic Reactions. Palonosetron may cause allergic reactions, which can be serious. Stop using palonosetron and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching or skin rash
  • Bumps on the skin called hives that can be red, pink, white, or brown depending on your skin tone
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Heart Rhythm Changes. Palonosetron may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take some medicines for other heart rhythm problems. Tell your health care provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Palonosetron can cause serotonin syndrome when it is used alone or with other medicines that affect serotonin (see the Interactions section for details). This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

  • Sweating, fever, or flushing
  • Confusion
  • Feeling agitated or restless
  • Seeing or hearing unusual things
  • Dizziness
  • Fast or racing heartbeat
  • Nausea, vomiting, or diarrhea
  • Muscle twitching, stiffness, or tremor
  • Seizures

Warnings & Precautions

Who should not use palonosetron?

Allergies to Ingredients. People who are allergic to any of the following should not use palonosetron.

  • Palonosetron
  • Aloxi
  • Posfrea
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific palonosetron products they stock.

What should I know about palonosetron before using it?

Palonosetron is given by a health care provider as an injection into a vein (IV). It is important to be on time for your appointments because palonosetron must be given at a specific time to make sure it works well to prevent nausea and vomiting.

What should I tell my health care provider before using palonosetron?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if palonosetron is right for you.

In particular, make sure that you discuss any of the following.

Other Medicines and Supplements. Palonosetron may increase your risk for serotonin syndrome (see the Side Effects section) if you are taking certain other medicines. Before using palonosetron, tell your health care provider about any medicines you are taking. See the Interactions section for more details.

Pregnancy. It is not known if or how palonosetron could affect pregnancy or harm a fetus. Tell your health care provider if you are or plan to become pregnant.

Breastfeeding. It is not known if palonosetron passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Interactions

Does palonosetron interact with foods or drinks?

There are no known interactions between palonosetron and foods or drinks.

It is unknown if drinking alcohol will affect palonosetron.

Does palonosetron interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before using palonosetron.

  • A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline, which is a medicine commonly used for anxiety and depression
  • A serotonin and norepinephrine reuptake inhibitor (SNRI), such as duloxetine or venlafaxine, which is a medicine commonly used for anxiety and depression
  • A triptan, such as eletriptan (Relpax), sumatriptan (Imitrex and others), and others, which is a medicine commonly used to treat migraines
  • A monoamine oxidase inhibitor (MAOI) within the past two weeks, which is a medicine usually used for depression or Parkinson’s disease

This may not be a complete list of medicines that can interact with palonosetron. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much palonosetron?

If you or someone else has used too much palonosetron, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of palonosetron?

Palonosetron is usually given by a health care provider in a hospital or clinic. Your health care provider will make sure you are receiving palonosetron as scheduled. If you miss an appointment to get your palonosetron dose, call to make another appointment as soon as possible.