Palonosetron Reig Jofre (Palonosetron)

Palonosetron is a selective 5‑HT3 receptor antagonist indicated for the prevention of nausea and vomiting in several clinical pathways.

• Chemotherapy‑induced nausea and vomiting (CINV): Provides long‑lasting protection against acute and delayed phases of CINV.
• Post‑operative nausea and vomiting (PONV): Reduces the incidence of nausea and vomiting after surgical procedures.
• Radiotherapy‑induced nausea and vomiting: Helps control nausea and vomiting associated with radiation treatment.

• Palonosetron binds with high affinity to the serotonin 5‑HT3 receptor on vagal afferent nerves and in the chemoreceptor trigger zone, blocking serotonin‑mediated signaling that initiates the vomiting reflex. Its prolonged receptor occupancy and allosteric effects contribute to extended anti‑emetic protection compared with first‑generation 5‑HT3 antagonists.

Adverse reactions to palonosetron are generally mild to moderate, but clinicians monitor for both common and rare events.

Common Side Effects

• Headache: mild to moderate intensity.
• Constipation: occasional bowel movement changes.
• Fatigue: general tiredness without specific cause.
• Diarrhoea: transient loose stools.
• Dizziness: brief episodes of light‑headedness.

Serious or Rare Side Effects

• QT interval prolongation: cardiac rhythm changes detectable on ECG.
• Severe hypersensitivity: rash, pruritus, angio‑edema, or anaphylaxis.
• Serotonin syndrome: rare when combined with other serotonergic agents.
• Cardiac arrhythmias: uncommon but potentially life‑threatening.
• Neuro‑muscular blockade: extremely rare neuromuscular effects.

Palonosetron should be used with careful clinical assessment and monitoring.

• Cardiac monitoring: patients with known prolonged QT interval should be evaluated before use.
• Concomitant serotonergic drugs: assess risk of serotonin syndrome when adding other agents.
• Electrolyte abnormalities: correct potassium, magnesium, and calcium levels prior to administration.
• Pregnancy and lactation: weigh the risk against the‑ benef benef benef benef benef 
• Renal ? 
• Store at below 25°C: keep in the original packaging, protect from moisture and light.

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