palonosetron hydrochloride: clinical use

Prescribing considerations

• Use before chemotherapy under appropriate medical supervision.
• Review QT-risk factors, electrolyte abnormalities and concurrent QT-prolonging treatment.
• Monitor patients with previous constipation or signs of subacute intestinal obstruction.
• Clinical data are unavailable in end-stage renal disease requiring haemodialysis.

Contraindications and cautions

• Hypersensitivity to palonosetron or any excipient in the selected product.

Monitoring

• Assess bowel function in people at risk of constipation, impaction or obstruction.
• Correct hypokalaemia and hypomagnesaemia before administration.
• Observe for serotonin-syndrome features with serotonergic medicines.
• Consider clinical and ECG assessment with significant QT-risk factors.

Clinical pharmacology

Palonosetron is a selective, high-affinity 5-HT3 receptor antagonist with a mean terminal elimination half-life of about 40 hours. Elimination is renal and metabolic.

Formulation and product differences

• Clear, colourless intravenous solution in a single-use vial.
• Use immediately after opening and discard unused solution.
• Do not mix with other medicines.
• Contains less than 1 mmol sodium per vial and is considered essentially sodium-free.

Injection

Route: Parenteral

Strengths: 250 micrograms