Pset 0.5 mg Tablet

Long-acting 5-HT3 antagonist anti-sickness medicine for:

• Prevention of nausea and vomiting caused by moderately and highly emetogenic cancer chemotherapy (acute and delayed)
• Prevention of post-operative nausea and vomiting (PONV)

Chemotherapy (adults): 0.25 mg IV as a single dose over 30 seconds, about 30 minutes before chemotherapy; or 0.5 mg capsule by mouth about 1 hour before. Do not repeat within 7 days.

Children 1 month–17 years (chemotherapy): 20 micrograms/kg IV (max 1.5 mg) as a single 15-minute infusion before chemotherapy.

Post-operative (adults): 0.075 mg IV immediately before anaesthesia induction.

• Often combined with dexamethasone and an NK1 antagonist (aprepitant/netupitant) for highly emetogenic chemotherapy.

• Allergy to palonosetron or other 5-HT3 antagonists (ondansetron, granisetron)

Common: headache, constipation, dizziness.

Less common: diarrhoea, tiredness, raised liver enzymes, irregular heartbeat, low/high blood pressure, insomnia.

Rare: serotonin syndrome (with other serotonergic drugs), severe allergic reactions, QT prolongation (less than older drugs).

• History of bowel obstruction or severe constipation: monitor.
• Heart rhythm problems, electrolyte imbalance: caution.

Limited data; use in pregnancy only if clearly needed. Avoid breastfeeding around treatment.

• SSRIs, SNRIs, tramadol, fentanyl, lithium, methylene blue (serotonin syndrome)
• Other QT-prolonging drugs (caution)

Little experience; supportive care.

Store below 30°C, protected from light. Do not freeze.