Palonosetronhydrochlorid Qilu (Palonosetron)

Palonosetron is a 5‑HT3 receptor antagonist indicated for prevention of nausea and vomiting associated with chemotherapy and surgery.

• Chemotherapy‑induced nausea and vomiting (CINV): helps prevent acute and delayed episodes in adult patients receiving highly emetogenic chemotherapy.
• Post‑operative nausea and vomiting (PONV): reduces incidence of nausea and vomiting after general anesthesia.
• Radiotherapy‑induced nausea and vomiting: mitigates nausea associated with high‑dose radiation therapy.
• Antiemetic prophylaxis in stem‑cell transplantation: provides nausea control during conditioning regimens.
• Nausea associated with opioid therapy: lessens nausea in patients receiving strong opioids.
• Antiemetic support for patients receiving multiple‑day chemotherapy protocols.

• Palonosetron binds with high affinity to the 5‑hydroxytryptamine type 3 (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, thereby inhibiting both acute and delayed phases of chemotherapy‑induced nausea and vomiting.

Palonosetron is generally well‑tolerated, but adverse reactions can occur.

Common Side Effects

• Headache: mild to moderate intensity.
• Constipation: transient bowel habit changes.
• Fatigue: general tiredness without specific cause.
• Dizziness: occasional light‑headed sensation.
• Injection site erythema: mild redness at the infusion site.

Serious or Rare Side Effects

• QT interval prolongation: may predispose to cardiac arrhythmias.
• Severe hypersensitivity: rash, pruritus, or anaphylaxis.
• Serotonin syndrome: rare when combined with other serotonergic agents.
• Cardiac arrest: extremely rare, reported in isolated cases.
• Persistent vomiting despite therapy: may indicate inadequate response.

Before administering Palonosetron, consider the following safety measures.

• Cardiac assessment: evaluate baseline ECG in patients with known QT prolongation risk.
• Concomitant serotonergic drugs: avoid or monitor for serotonin syndrome.
• Electrolyte balance: correct hypokalemia, hypomagnesemia, or hypocalcemia before use.
• Pregnancy and lactation: use only if clearly needed.
• Renal or hepatic impairment: dose adjustment may be required; monitor liver function tests.
• Store at ambient temperature: keep in original packaging, protect from moisture.

Palonosetron may interact with several drug classes; monitoring is advised.

Major Interactions (Avoid)

• Other 5‑HT3 antagonists: concurrent use can increase risk of cardiac effects.
• QT‑prolonging agents: additive risk of arrhythmia, especially in patients with cardiac disease.

Moderate Interactions (Monitor Closely)

• Serotonergic agents (e.g., SSRIs, MAO inhibitors): may increase risk of serotonin syndrome.
• CYP3A4 inhibitors/inducers: may alter palyto‑exposure levels, requiring observation.
• Anticholinergic drugs: may affect gastrointestinal motility and nausea control.
• Diuretics causing electrolyte loss: monitor electrolytes to reduce QT risk.