Palonosetron Accord (Palonosetron)

Palonosetron is indicated for the prevention of chemotherapy‑induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV). It works within the serotonergic pathway to reduce emesis.

• Chemotherapy‑induced nausea and vomiting: provides effective prophylaxis for acute and delayed phases.
• Post‑operative nausea and vomiting: reduces incidence of nausea and vomiting after general anesthesia.
• Radiotherapy‑induced nausea and vomiting: helps control nausea associated with radiation treatment.

• Palonosetron selectively binds to the 5‑HT₃ receptors in the central nervous system and gastrointestinal tract, blocking serotonin‑mediated signaling that triggers the vomiting reflex. Its high affinity and long half‑life provide extended protection against both acute and delayed emetic stimuli.

Palonosetron may cause a range of adverse reactions, most of which are mild to moderate in intensity.

Common Side Effects

• Headache: mild to moderate intensity.
• Constipation: occasional bowel movement changes.
• Fatigue: general feeling of tiredness.
• Dizziness: transient light‑headedness.
• Injection site reactions: erythema or mild pain.

Serious or Rare Side Effects

• Hypersensitivity reactions: rash, pruritus, or anaphylaxis.
• Cardiac arrhythmias: QT‑interval prolongation.
• Severe constipation or intestinal obstruction.
• Serotonin syndrome: rare when combined with other serotonergic agents.
• Neurotoxicity: rare central nervous system effects.

When using Palonosetron, certain precautions should be observed to ensure safe administration.

• Assess patient history: evaluate for prior hypersensitivity to 5‑HT₃ antagonists.
• Monitor cardiac status: consider ECG monitoring in patients with known QT prolongation.
• Review concomitant medications: avoid drugs that may prolong QT interval.
• Adjust for renal/hepatic impairment: dose may need modification in severe dysfunction.
• Pregnancy and lactation: use only if clearly needed.
• Store at ambient temperature: keep below 25°C, protect from moisture and light.

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