Palonosetron Kalceks (Palonosetron)

Palonosetron Kalceks is a selective 5‑HT3 receptor antagonist indicated for several nausea‑vomiting pathways.

• Chemotherapy‑induced nausea and vomiting (CINV): provides effective prophylaxis in patients receiving highly emetogenic chemotherapy.
• Post‑operative nausea and vomiting (PONV): reduces the incidence of nausea and vomiting after surgery.
• Radiotherapy‑induced nausea and vomiting (RINV): helps control nausea associated with radiation treatment.
• Anticipatory nausea and vomiting: lessens nausea that occurs before chemotherapy in patients with a history of CINV.

• Palonosetron binds with high affinity to the serotonin 5‑HT3 receptors located on vagal afferent nerves in the gastrointestinal tract and the chemoreceptor trigger zone. By blocking these receptors, it prevents serotonin‑mediated activation of the vomiting centre, providing a prolonged anti‑emetic effect that lasts up to 72 hours after a single dose.

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

Common Side Effects

• Headache: mild to moderate intensity.
• Constipation: occasional bowel habit changes.
• Fatigue: general tiredness without specific cause.
• Dizziness: transient light‑headed sensations.

Serious or Rare Side Effects

• QT interval prolongation: may affect cardiac rhythm.
• Severe hypersensitivity: including rash, pruritus, or anaphylaxis.
• Serotonin syndrome: rare when combined with other serotonergic agents.
• Persistent arrhythmia: uncommon cardiac rhythm disturbances.

When prescribing Palonosetron Kalceks, clinicians should consider several safety aspects.

• Cardiac monitoring: assess baseline ECG in patients with known QT prolongation risk.
• Concomitant serotonergic drugs: evaluate for additive serotonin effects.
• Renal impairment: adjust clinical judgment in severe kidney dysfunction.
• Hepatic impairment: use caution in patients with significant liver disease.
• Pregnancy and lactation: weigh benefits against potential risks; use only if clearly needed.

Store at ambient temperature: keep in original packaging, protect from moisture and light.

Palonosetron may interact with other medications, requiring attention to avoid reduced efficacy or increased toxicity.

Major Interactions (Avoid)

• Class I anti‑arrhythmic drugs (e.g., quinidine) that prolong QT interval.
• Other potent 5‑HT3 antagonists used concurrently.

Moderate Interactions (Monitor Closely)

• Serotonergic agents (e.g., SSRIs, SNRIs, tramadol) – monitor for serotonin syndrome.
• CYP3A4 inhibitors (e.g., ketoconazole) – may increase palonosetron plasma levels.
• CYP3A4 inducers (e.g., rifampicin) – may reduce palonosetron exposure.