Palonosetron Dosage

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Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for Nausea/Vomiting - Chemotherapy Induced

Parenteral: 0.25 mg IV as a single dose 30 minutes before the start of chemotherapy.

Oral: 0.5 mg orally administered approximately 1 hour prior to the start of chemotherapy.

Usual Adult Dose for Nausea/Vomiting - Postoperative

0.075 mg IV as a single dose immediately before induction of anesthesia.

Usual Pediatric Dose for Nausea/Vomiting - Chemotherapy Induced

The dosing information for children and adolescents for prevention of acute chemotherapy-induced nausea and vomiting is based on clinical trials:

Kadota (2007): A randomized trial of 60 pediatric patients greater than 2 years of age [12 patients (1 month to 2 years) treated in an open-label fashion] showed 3 mcg/kg (maximum dose: 0.25 mg) and 10 mcg/kg (maximum dose: 0.75 mg) were well-tolerated and effective (no emesis, no rescue first 0 to 24 hours).

Sepulveda-Vildosola (2008): A randomized comparison of palonosetron (0.25 mg single dose 30 minutes before chemotherapy) and ondansetron (8 mg/m2 every 8 hours beginning 30 minutes before chemotherapy) in children 2 to 15 years, evaluated 100 chemotherapy courses in each arm and showed a statistically significant reduction in emetic events on days 2 to 3 in the palonosetron group and clinically significant reduction in emetic events on days 4 to 7 (up to 6 emetic events in the ondansetron group versus none with palonosetron).

Renal Dose Adjustments

No adjustment recommended

Liver Dose Adjustments

No adjustment recommended

Precautions

Repeat dosing within a 7 days interval is not recommended.

Palonosetron may increase large bowel transit time; therefore, it is recommended to monitor patients with a history of constipation or signs of subacute intestinal obstruction following administration.

Safety and effectiveness have not been established in pediatric patients (less than 18 years of age).

Dialysis

Data not available

Other Comments

Palonosetron is to be infused intravenously over 30 seconds.

Palonosetron may be given orally without regard to meals.

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