Palonosetron HCl (Aloxi®)

Author: OncoLink Team
Last Reviewed: February 13, 2020

Pronounced: 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 Palonosetron

Palonosetron is given intravenously (IV, into a vein). Your care provider will determine the 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 for much longer. Confirm with your healthcare team when and if you should take ondansetron. Taking both palonosetron and ondansetron together can lead to more side effects and not necessarily more benefit.

At times this medication can cause a feeling of discomfort or burning at the infusion site. Notify your nurse 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 of Palonosetron

There are a number of things you can do to manage the side effects of palonosetron. Talk to your care team about these recommendations. They can help you decide what will work best for you. These are some of the most common or important side effects:

Headache

Your healthcare provider can recommend medications and other strategies to help relieve pain.

Constipation

There are several things you can do to prevent or relieve constipation. Include fiber in your diet (fruits and vegetables), drink 8-10 glasses of non-alcoholic fluids a day, and keep active. A stool softener once or twice a day may prevent constipation. If you do not have a bowel movement for 2-3 days, you should contact your healthcare team for suggestions to relieve constipation.

Less common, but important side effects can include:

  • Allergic Reactions: In some cases, patients can have an allergic reaction to this medication. Signs of a reaction can include: fever, chills, rash, or breathing problems. If you notice any changes in how you feel, let your nurse know immediately.
  • 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.

Reproductive Concerns 

You should consult with your healthcare team prior to becoming pregnant, fathering a child or breastfeeding while receiving this medication.  

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