Palonosetron Reig Jofre (Palonosetron)

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

• Chemotherapy‑induced nausea and vomiting (CINV): Provides long‑lasting protection against acute and delayed episodes.
• Post‑operative nausea and vomiting (PONV): Reduces the incidence of nausea and vomiting after general anesthesia.
• Radiotherapy‑induced nausea and vomiting: Helps control nausea associated with radiation treatment.
• Antiemesis in patients receiving highly emetogenic chemotherapy: Offers enhanced control compared with older 5‑HT3 agents.

• Palonosetron binds with high affinity to the 5‑HT3 receptors located on peripheral vagal nerve terminals and centrally in the chemoreceptor trigger zone. By blocking serotonin from activating these receptors, it interrupts the signaling cascade that triggers the vomiting reflex, providing prolonged anti‑emetic protection 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 slowing.
• Fatigue: general tiredness.
• Dizziness: transient light‑headedness.
• Injection site erythema: mild redness at the site of administration.

Serious or Rare Side Effects

• QT interval prolongation: may predispose to cardiac arrhythmias.
• Severe hypersensitivity: including anaphylaxis, rash, or angio‑edema.
• Serotonin syndrome: rare but potentially life‑threatening when combined with other serotonergic agents.
• Persistent severe constipation: may require medical intervention.
• Cardiac arrhythmia: uncommon but serious cardiac rhythm disturbances.

When using Palonosetron, clinicians should consider several safety aspects before and during therapy.

• Assess cardiac history: patients with known QT prolongation should be evaluated carefully.
• Review concomitant medications: avoid drugs that also prolong the QT interval.
• Monitor electrolytes: correct hypokalemia, hypomagnesemia, or hypocalcaemia which can exacerbate QT issues.
• Use with caution in hepatic ​  
• Use   
• Store at ambient temperature: keep  

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