Generic Medicine Info
Indications and Dosage
Nausea and vomiting associated with cancer chemotherapy
Adult: 250 mcg by bolus inj over 30 sec to be given approx 30 min before chemotherapy.
Child: 1 mth to 17 yr 20 mcg/kg (max: 1,500 mcg) by infusion over 15 min to be given approx 30 min before chemotherapy.

Prophylaxis of postoperative nausea and vomiting
Adult: 75 mcg by bolus inj over 10 sec immediately before induction of anaesthesia.

Nausea and vomiting associated with cancer chemotherapy
Adult: 500 mcg 1 hr before chemotherapy.
Special Precautions
Patient w/ history of constipation, intestinal obstruction, history or risk of QT interval prolongation, electrolyte abnormalities. Childn. Pregnancy and lactation.
Adverse Reactions
Significant: QT prolongation, bradycardia, hypersensitivity reactions (e.g. anaphylaxis).
Nervous: Headache, dizziness, somnolence, fatigue, weakness, anxiety, vertigo, flu-like symptoms, insomnia, paresthesia.
CV: Nonsustained tachycardia, hypotension, HTN, MI, hot flush.
GI: Constipation, diarrhoea, abdominal pain, dyspepsia, dry mouth, hiccups, flatulence, anorexia.
Hepatic: Increased serum ALT/AST, bilirubin.
Genitourinary: Urinary retention.
Endocrine: Hyperkalaemia, electrolyte fluctuations, hyperglycaemia, metabolic acidosis, glycosuria.
Musculoskeletal: Arthralgia.
Ophthalmologic: Amblyopia.
Otic: Tinnitus.
Dermatologic: Pruritus, rash, allergic dermatitis.
Others: Inj site reaction.
Potentially Fatal: Rarely, serotonin syndrome (e.g. altered mental status, autonomic instability, neuromuscular symptoms).
IV/Parenteral/PO: B
Patient Counseling Information
This drug may cause dizziness, somnolence or fatigue, if affected, do not drive or operate machinery.
Monitoring Parameters
Monitor for signs and symptoms of serotonin syndrome.
Drug Interactions
Decreased therapeutic effect of tramadol.
Potentially Fatal: Increased risk of serotonin syndrome w/ serotonergic agents [e.g. SSRI, serotonin and norepinephrine reuptake inhibitors (SNRIs), MAOIs, mirtazapine].
Description: Palonosetron is a selective high-affinity receptor antagonist of 5-HT3 receptor w/ little or no affinity for other serotonin receptors. It blocks serotonin peripherally on vagal nerve terminals and centrally in the chemoreceptor trigger zone.
Absorption: Well absorbed from the GI tract. Absolute bioavailability: 97% (oral). Time to peak plasma concentration: Approx 5 hr (oral).
Distribution: Volume of distribution: Approx 7-8 L/kg. Plasma protein binding: Approx 62%.
Metabolism: Metabolised by CYP to inactive metabolite, N-oxide-palonosetron and 6-S-hydroxy-palonosetron.
Excretion: Mainly via urine (80%; 40%, as unchanged drug); faeces (5-8%). Elimination half-life: Approx 40 hr.
Chemical Structure

Chemical Structure Image

Source: National Center for Biotechnology Information. PubChem Database. Palonosetron, CID=6337614, (accessed on Jan. 22, 2020)

Store between 20-25°C. Protect from light.
MIMS Class
Antiemetics / Supportive Care Therapy
ATC Classification
A04AA05 - palonosetron ; Belongs to the class of serotonin (5HT3) antagonists. Used for the prevention of nausea and vomiting.
Aloxi Palonosetron Hydrochloride Injection (Eisai Inc.). DailyMed. Source: U.S. National Library of Medicine. Accessed 20/09/2017.

Anon. Palonosetron. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. Accessed 20/09/2017.

Buckingham R (ed). Palonosetron Hydrochloride. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. Accessed 20/09/2017.

Joint Formulary Committee. Palonosetron. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. Accessed 20/09/2017.

McEvoy GK, Snow EK, Miller J et al (eds). Palonosetron Hydrochloride. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). Accessed 20/09/2017.

Disclaimer: This information is independently developed by MIMS based on Palonosetron from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2022 MIMS. All rights reserved. Powered by
  • Aloxi
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in