Palonosetron

Palonosetron is a 5-ht3 receptor antagonist antiemetic medicine available in Bangladesh under many brand names. Below are its uses, dosage, side effects and precautions — and all brands with their current prices.

• Prevention of nausea and vomiting associated with moderately or highly emetogenic cancer chemotherapy in adults.
• Prevention of delayed nausea and vomiting after moderately emetogenic chemotherapy.
• Prevention of postoperative nausea and vomiting in adults when the injection form is used around surgery.

Adult dosing depends on the indication, dosage form, chemotherapy regimen, and surgical setting. Palonosetron is usually given as a single dose before chemotherapy or before anaesthesia/surgery; oral forms are taken by mouth and injection is given by a healthcare professional. Follow the exact dose and timing prescribed by the doctor and do not repeat doses unless instructed.

• Common effects may include headache, constipation, dizziness, tiredness, and diarrhoea.
• Injection may cause pain, redness, or irritation at the injection site.
• Serious but uncommon effects include allergic reactions such as rash, swelling, breathing difficulty, severe constipation or bowel problems, and serotonin syndrome, especially when used with serotonergic medicines.
• Seek urgent medical help for chest pain, fainting, severe dizziness, irregular heartbeat, or signs of a serious allergy.

Use with caution in people with a history of allergy to 5-HT3 antiemetics, significant constipation or bowel obstruction, heart rhythm problems, electrolyte imbalance, or those taking medicines that increase serotonin. Tell the doctor about all prescription, over-the-counter, and herbal medicines before use. Use this medicine under the guidance of a registered doctor or pharmacist.

• Medicines that increase serotonin, such as SSRIs, SNRIs, MAO inhibitors, mirtazapine, tramadol, linezolid, lithium, and St. John’s wort, may increase the risk of serotonin syndrome.
• Other medicines that can affect heart rhythm may need caution, especially in patients with cardiac risk factors or electrolyte abnormalities.
• No important food interaction is well established, but alcohol may worsen dizziness or tiredness in some people.

• Known hypersensitivity to palonosetron or any component of the formulation.
• History of serious allergic reaction to palonosetron or closely related 5-HT3 receptor antagonists should be discussed with a doctor before use.

Pregnant or breastfeeding women should use palonosetron only when the expected benefit justifies any potential risk and after advice from a doctor. It is not known with certainty whether palonosetron passes into human breast milk, so a clinician should help decide whether to use the medicine or interrupt breastfeeding.

Store at room temperature, away from excess heat, moisture, and direct light. Keep tablets, capsules, ODTs, and injections in their original packaging until use, and keep all medicines out of the reach of children. Injection should be stored and handled according to the product label and used only by trained healthcare personnel.