Palonosetron HCl (Aloxi®)
Pronounce: pal-oh-NOE-se-tron
Classification: Antiemetic; Selective 5-HT3 Receptor Antagonist
About Palonosetron HCl (Aloxi®)
Palonosetron is a selective 5-HT3 receptor antagonist. 5-HT3 receptors are found on areas of nerves in the brain and stomach that can trigger a vomiting reflex. Palonosetron stops this reflex and helps prevent and manage acute and delayed nausea and vomiting.
How to Take This Medication
Palonosetron is given intravenously (IV, into a vein). Your provider will prescribe your exact dosage and dosing schedule. It is recommended that palonosetron be given about 30 minutes before your dose of chemotherapy. If you are given this medication, you should not need to take ondansetron (Zofran) for 3–5 days after, since palonosetron works in a similar way but for much longer. Ask your provider when and if you should take ondansetron. Taking both palonosetron and ondansetron together can lead to more side effects and not necessarily help more.
This medication can cause a feeling of discomfort or burning at the infusion site. Notify your provider if you have discomfort or burning.
Taking this medication with serotonergic medications (often used to treat migraines and depression) can lead to serotonin syndrome. Symptoms of serotonin syndrome that you should notify your provider of include changes in your mental status (agitation, hallucinations, coma), your nervous system (change in heart rate or blood pressure, sweating, dizziness), or in how your muscles are working (tremors, trouble walking). You should call your provider if you are having any symptoms of serotonin syndrome.
Possible Side Effects
These are some of the most common or most serious side effects of this medication. Talk with your provider about the side effects you are having and how they can be managed.
Headache
Your provider can suggest medications and other ways to help relieve your pain.
Constipation
Constipation is when you have less bowel movements than usual or are having trouble passing stool. To relieve constipation, you can include fiber in your diet (fruits like prunes, apples, peaches, and pear nectars/juices), drink 8 to 10 glasses of non-alcoholic fluids a day, and stay active. Taking a stool softener once or twice a day can prevent constipation. If you do not have a bowel movement for 2 to 3 days, call your provider.
Reproductive Concerns
Talk with your provider before becoming pregnant, getting someone pregnant, or breastfeeding while receiving this medication.
Important but Less Common Side Effects
Allergic Reactions
Some people may have an allergic reaction to this medication. Signs of an allergic reaction are:
- Shortness of breath or trouble breathing.
- Chest pain.
- Rash.
- Itching.
- Flushing (reddening of the skin, often on the face, neck, or chest).
- A drop in blood pressure (you may feel lightheaded, dizzy, or weak).
If you have any of these signs while you are getting an infusion, tell your provider right away. The infusion will be slowed down or stopped. Depending on your reaction, you may still be able to get the medication if you are given medicine to prevent a reaction or if the medication is given at a slower rate.
Serotonin Syndrome
Taking this medication with other medications that raise serotonin in your body, like those used to treat migraines or depression, can raise your risk of serotonin syndrome. Call your provider right away if you have symptoms of serotonin syndrome, which may be:
- Feeling restless or agitated.
- Not being able to sleep (insomnia).
- Feeling confused.
- Fast heart rate.
- Tight muscles.
- Trouble walking.
- Changes in your blood pressure.
- Dizziness.
- Sweating.
- Diarrhea.
- Headache.
Some medications that raise serotonin levels are Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs), triptans used for migraines, opioid pain medications, and Tricyclic Antidepressants (TCAs). Tell your provider about all medications you are taking.