Introduction
Palotic is an antiemetic medicine commonly used to control nausea and vomiting due to certain medical conditions like stomach upset. It is also used to prevent nausea and vomiting caused due to any surgery, cancer drug therapy or radiotherapy.
Palotic will not relieve other side effects associated with cancer treatments. It also has little effect on vomiting caused by motion sickness. You should take this medicine in the dose and duration advised by your doctor. But, it is better to take this medicine at a fixed time. Remember you should not stop taking the medication suddenly without talking to your doctor. In case you vomit within one hour of taking a dose then take another dose and avoid heavy meals throughout the day.
The most common side effects of taking this medicine include headache and constipation. Dizziness and sleepiness may also occur, so do not drive or do anything that requires mental focus until you know how this medicine affects you. These symptoms should disappear when you stop taking the medicine. However, if these bother you or do not go away, consult your doctor who may be able to suggest ways of preventing or reducing them.
Before taking this medicine, tell your doctor if you have heart or liver problems or a blockage in your stomach or intestines. Also, tell your doctor about any other medicine you are using, especially medicines to treat epilepsy, heart problems, cancer and depression. These may affect, or be affected by, this medicine. If you are pregnant or breastfeeding, ask for advice from your healthcare team.
How to use Palotic
Take this medicine in the dose and duration as advised by your doctor. Do not handle the tablets with wet hands. Put it in your mouth but do not swallow it. Palotic may be taken with or without food, but it is better to take it at a fixed time.
How Palotic works
Palotic is an antiemetic medication. It works by blocking the action of a chemical messenger (serotonin) in the brain that may cause nausea and vomiting during anti-cancer treatment (chemotherapy) or after surgery.
What if you forget to take Palotic?
If you miss a dose of Palotic, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular schedule. Do not double the dose.
Indication
Chemotherapy-induced nausea and vomiting, Postoperative nausea and vomiting
Administration
Reconstitution: Physically and chemically stable at concentrations of 5 and 30 mcg/ml in glucose 5%, sodium chloride 0.9%, glucose 5% in lactated Ringer's for at least 48 hr at room temperature, exposed to light and for 14 days under refridgeration.
IV Administration
Flush IV line with NS before and after administration
CINV: give IVP evenly over 30 sec (adults) or 15 min (children)
PONV: IVP over 10 sec
Adult Dose
Prevention of Chemotherapy-induced Nausea & Vomiting
Intravenous
Adult: 0.25 mg IV as a single dose. To be given over 30 sec and 30 minutes before chemotherapy. Do not repeat within 7 days.
Oral
Alternatively 0.5 mg tablet/capsule approximately 1 hour before the start of chemotherapy. Then 0.5 mg tablet once daily.
Prevention of Postoperative Nausea & Vomiting
Adult: 0.075 mg IV as a single dose immediately before induction of anaesthesia.
Hepatic impairment: Dose adjustment not necessary
Child Dose
Prevention of Postoperative Nausea & Vomiting
<18 years: Safety and efficacy not established
Prevention of Chemotherapy-induced Nausea & Vomiting
<1 month: Safety and efficacy not established
1 month to 17 years: 20 mcg/kg IV infused over 15 minutes x1, beginning 30 minutes before chemotherapy; not to exceed 1.5 mg/dose
Renal Dose
Renal impairment: Dose adjustment not necessary
Contraindication
History of hypersensitivity.
Mode of Action
Palonosetron is a selective 5-HT3 antagonist that is used in the prevention of acute and delayed emesis in emetogenic cancer chemotherapy regimens.
Precaution
Patients with intestinal obstruction or ileus. Rapid inj may lead to temporary visual changes e.g. blurred vision. Patients who have or may develop prolonged QT intervals. Safety and efficacy not established in children <18 yr. Counsel patients who handle skilled tasks e.g. driving may be impaired.
Lactation: unknown, discontinue drug or do not nurse
Side Effect
1-10%
Prolonged QT interval (up to 5% ),Anxiety,Dizziness,Headache,Weakness,Constipation,Diarrhea,Prutitus,Hyperkalemia,LFT's increased
<1%
First degree atrioventricular block,Second degree atrioventricular block
Frequency Not Defined
Immune hypersensitivity reaction (very rare),Seizure
Interaction
May have additive effect on prolonging QT with drugs e.g. moxifloxacin, erythromycin, antipsychotics and TCAs.
