Intravenous Treatment and prophylaxis of postoperative nausea and vomiting
Adult: 12.5 mg once daily as IV push over 30 seconds or via infusion over 15 min; given as soon as nausea or vomiting present (treatment) or approx 15 min before cessation of anaesthesia (prophylaxis).
Oral Nausea and vomiting associated with cancer chemotherapy
Adult: 100 or 200 mg once daily w/in 1 hr before chemotherapy. Duration of treatment: 4-7 consecutive days/chemotherapy cycle.
Oral Prophylaxis of postoperative nausea and vomiting
Adult: 50 mg at the induction of anaesthesia, or 100 mg w/in 2 hr before surgery.
IV infusion: Dilute in 50 ml of a compatible soln (i.e. NaCl 0.9%, dextrose 5%, Lactated Ringer’s soln, dextrose 5% and Lactated Ringer’s soln, dextrose 5% and NaCl 0.45%, and mannitol 10% inj).
Patient w/ history of abnormal heart rhythms, structural heart disease, sick sinus syndrome, AF w/ slow ventricular response, myocardial ischemia, electrolyte abnormalities (i.e. hypokalaemia, hypomagnesemia). IV admin is not intended for prophylaxis of chemotherapy-associated nausea and vomiting. Pregnancy and lactation.
Symptoms: Severe hypotension, dizziness; PR, QRS, and QT prolongation. Management: Symptomatic and supportive treatment. Monitor cardiac function.
Increased risk of QT prolongation w/ other QT prolonging agents (e.g. pimozide, ziprasideone) and drugs known to cause electrolyte imbalance (e.g. diuretics). Decreased blood levels and therapeutic effects w/ rifampicin. Increased blood levels and effects w/ atenolol and cimetidine. Increased risk of conduction abnormalities when concurrently used w/ antiarrhythmic agents (e.g. verapamil, flecainide, quinidine).
Description: Dolasetron, a selective serotonin (5-HT3) receptor antagonist, has antiemetic actions similar to ondansetron. It blocks serotonin both peripherally at the GI tract (main site of action) and centrally at the chemoreceptor trigger zone. Pharmacokinetics: Absorption: Rapid and completely absorbed (oral). Bioavalability: Approx 75%. Time to peak plasma concentration: Hydrodolasetron: Approx 1 hr (oral); 0.6 hr (IV). Distribution: Widely distributed in the body. Volume of distribution: 5-7.9 L/kg. Plasma protein binding: 69-77%. Metabolism: Rapidly metabolised hepatically via reduction by carbonyl reductase to hydrodolasetron (active metabolite); further metabolised by CYP2D6, CYP3A, and flavin monooxygenase enzymes. Excretion: Via urine (approx 67%); faeces (approx 33%). Elimination half-life: Dolasetron: ≤10 min (IV); hydrodolasetron: 8.1 hr (oral); 7.3 hr (IV).
A04AA04 - dolasetron ; Belongs to the class of serotonin (5HT3) antagonists. Used for the prevention of nausea and vomiting.
Anon. Dolasetron. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 27/02/2017.Anzemet Injection (Sanofi-Aventis U.S. LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 27/02/2017.Anzemet Tablet, Film Coated (Validus Pharmaceuticals LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 27/02/2017.Buckingham R (ed). Dolasetron Mesilate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com . Accessed 27/02/2017.McEvoy GK, Snow EK, Miller J et al (eds). Dolasetron Mesylate. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 27/02/2017.