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| (dahl-AH-set-rahn) |
| Anzemet |
| Class: Antiemetic/Antinauseant |
Action Selective serotonin (5–HT3) receptor antagonist that inhibits serotonin receptors in the GI tract and chemoreceptor zone.
Indications Parenteral or oral: Prevention of nausea and vomiting associated with initial and repeat courses of emetogenic chemotherapy; prevention of postoperative nausea and vomiting in patients at risk. Parenteral only: Treatment of postoperative nausea and vomiting. Unlabeled use(s): Radiotherapy-induced nausea and vomiting.
Contraindications Standard considerations.
Prevention of Chemotherapy-Induced Nausea and Vomiting
ADULTS & CHILDREN > 16 YR: PO 100 mg within 1 hr before chemotherapy. IV 1.8 mg/kg (or 100 mg) infused rapidly over 30 seconds or diluted and infused over 15 min, 30 min before chemotherapy. CHILDREN 2–16 YR: PO 1.8 mg/kg (maximum of 100 mg) within 1 hr before chemotherapy. IV 1.8 mg/kg (maximum of 100 mg) infused rapidly over 30 seconds or diluted and infused over 15 min, 30 min before chemotherapy.
Prevention of Postoperative Nausea and Vomiting in Patients at Risk
ADULTS & CHILDREN > 16 YR: PO 100 mg within 2 hrs before surgery. IV 12.5 mg 15 min before cessation of anesthesia. CHILDREN 2–16 YR: PO 1.2 mg/kg (maximum of 100 mg) within 2 hr before surgery. IV 0.35 mg/kg (maximum of 12.5 mg) 15 min before cessation of anesthesia.
Treatment of Postoperative Nausea and Vomiting
ADULTS & CHILDREN > 16 YR: IV 12.5 mg as a single dose as soon as nausea and vomiting presents. CHILDREN 2–16 YR: IV 0.35 mg/kg as a single dose as soon as nausea and vomiting present.
Drugs which prolong the QTc interval (eg, quinidine, etc): Additive effects on conduction. Atenolol: Increased serum levels of active metabolite (IV only). Cimetidine: Increased serum levels of active metabolite. Rifampin: Decreased serum levels of active metabolite.
Lab Test Interferences None well documented.
CV: Tachycardia; bradycardia; flushing; hypertension; hypotension. CNS: Headache; vertigo; dizziness agitation; drowsiness; sleep disorder; depersonalization. DERM: Rash; itching; sweating. GI: Abdominal pain; constipation; diarrhea; dyspepsia; anorexia; taste perversion; abnormal liver function. GU: Oliguria; urinary retention. OTHER: Fever; fatigue; pain; chills; shivering.
Pregnancy: Category B. Lactation: Undetermined. Children: Safety and efficacy in children < 2 yr not established. ECG Changes: Can cause ECG interval change (PR, QTc, JT) prolongation and QRS widening) which could cause cardiovascular consequences, including heart block and arrhythmias. These changes are related in magnitude and frequency to the active metabolite. Conditions predisposing to prolongation of cardiac conduction intervals (eg, electrolyte abnormalities, class 1A antiarrhythmias, etc): Use with caution.
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