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Serotinin Inhibitor, Antiemetic,
Anzemet, Dolasetron Mesylate

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This page was prepared by Lynn Kash, RN, Internet Nursing Guide
Pennsylvania Nurses,Emergency Department
http://www.nursefriendly.com/kash/

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Dolasetron Mesylate, Classification, Action, How Drug is Given, American Cancer Society:" Dolasetron mesylate belongs to a general class of drugs called serotonin antagonists. It is an anti-nausea medicine.

Dolasetron mesylate blocks the serotonin pathway by which chemotherapy stimulates the vomiting center in the brain.

Dolasetron mesylate can be given intravenously or orally. It is given intravenously just prior to chemotherapy, and one hour before chemotherapy when given by mouth. Keep pills in a tightly closed container and out of the reach of children."
American Cancer Society
1599 Clifton Road, Atlanta, GA 30329
1-800-ACS-2345
http://www.cancer.org/

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ANZEMET® Injection (dolasetron mesylate injection), Indications and usage, Anzemet.com:"ANZEMET Injection is indicated for the following: (1) the prevention of nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including high dose cisplatin; (2) the prevention of postoperative nausea and vomiting. As with other antiemetics, routine prophylaxis is not recommended for patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively. In patients where nausea and/or vomiting must be avoided postoperatively, ANZEMET Injection is recommended even where the incidence of postoperative nausea and/or vomiting is low; (3) the treatment of postoperative nausea and/or vomiting."
Aventis Pharmaceuticals Inc.
300 Somerset Corporate Boulevard, Bridgewater, NJ 08807-2854
1-800-981-2491
http://www.aventispharma-us.com/

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Dolasetron, What are the possible side effects of dolasetron, Drugs.com:"If you experience any of the following uncommon but serious side effects, stop taking dolasetron and seek emergency medical attention or contact your doctor immediately: an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives); irregular heartbeats; or muscle cramps or uncontrollable movements.

Other, less serious side effects may be more likely to occur. Continue to take dolasetron and talk to your doctor if you experience: headache; fatigue, drowsiness, or dizziness; or diarrhea."
Drugs.com
P.O. Box 302739, North Harbour, Auckland, Auckland 1330, NZ
http://www.drugs.com/

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Dolasetron, What are the precautions when taking this medicine, HealthandAge.com:"You may not be alert. Avoid driving, doing other tasks or activities until you see how this medicine affects you. Tell healthcare provider if you are allergic to any medicine. Make sure to tell about the allergy and how it affected you. This includes telling about rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, throat; or any other symptoms involved. Tell healthcare provider if you are pregnant or plan on getting pregnant. Tell healthcare provider if you are breast-feeding."
Norvartis
575 Eighth Avenue New York, NY 10018
US Phone: (212) 798 - 9107
http://www.healthandage.com/

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Dolasetron, How should this medicine be used, MEDLINEplus:"Dolasetron comes as a tablet to take by mouth and in an injectable form. The tablets may be taken with or without food. The first dose of dolasetron usually is taken in a hospital or clinic 30 minutes before chemotherapy is begun or 15 minutes before anesthesia is stopped. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take dolasetron exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor. Dolasetron injections are given by qualified health care professionals."
Office of Communications and Public Liaison
National Library of Medicine
8600 Rockville Pike Bethesda, Maryland 20894
Phone: (301) 496-6308 Fax: (301) 496-4450 email: publicinfo@nlm.nih.gov
http://www.nlm.nih.gov/medlineplus/

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Dolasetron, Dosage and Administration:"ANZEMET Tablets are indicated for: 1) the prevention of nausea and vomiting associated with moderately-emetogenic cancer chemotherapy, including initial and repeat courses; 2) the prevention of postoperative nausea and vomiting.

Prevention of Cancer Chemotherapy-Induced Nausea and Vomiting: Adults: The recommended oral dosage of ANZEMET (dolasetron mesylate) is 100 mg given within one hour before chemotherapy.

Pediatric Patients: The recommended oral dosage in pediatric patients 2 to 16 years of age is 1.8 mg/kg given within one hour before chemotherapy, up to a maximum of 100 mg. Safety and effectiveness in pediatric patients under 2 years of age have not been established. Use in the Elderly, Renal Failure Patients, or Hepatically Impaired Patients: No dosage adjustment is recommended."
RxList - The Internet Drug Index: Searchable drug database. RxList LLC
500 3rd Street Suite 530
San Francisco, CA 94107
707-747-0985 fax: 708 575 8638,info@rxlist.com
http://www.rxlist.com/

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ANZEMET™, Action And Clinical PharmacologyRxMed.com:"Dolasetron and its active metabolite, hydrodolasetron (MDL 74156), are selective 5-HT3 receptor antagonists shown not to have activity at other known serotonin receptors and with low affinity for dopamine receptors. The serotonin 5-HT3 receptors are located on the nerve terminals of the vagus in the periphery and centrally in the chemoreceptor trigger zone of the area postrema. It is thought that chemotherapeutic agents produce nausea and vomiting by releasing serotonin from the enterochromaffin cells of the small intestine, and that serotonin then activates the 5-HT3 receptors located on vagal afferents to initiate the vomiting reflex.

Acute, reversible, ECG changes (PR and QTc; QRS widening), caused by dolasetron, have been observed in controlled clinical trials. Dolasetron appears to prolong both depolarization and, to a lesser extent, repolarization time. Although QTc prolongation is primarily due to QRS widening, JT prolongation has also been observed. The magnitude and frequency of the ECG changes increased with dose (related to the peak plasma concentration of hydrodolasetron but not the parent compound). These ECG changes usually returned to baseline within 6 to 8 hours, but in some patients have lasted 24 hours or longer. Dolasetron administration has little or no effect on blood pressure."
RxMed Inc.
1450, Kingston Rd, Suite 6B
Pickering, ONTARIO L1V1C1 CA
905-831-8240,
http://www.rxmed.com/b.main/b2.pharmaceutical/b2.prescribe.html

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Dolasetron, What special precautions should I follow, SafeMedication.com:"Before taking dolasetron, tell your doctor and pharmacist if you are allergic to dolasetron, granisetron (Kytril), ondansetron (Zofran), or any other drugs. Tell your doctor and pharmacist what prescription and nonprescription medications you are taking, especially acebutolol (Sectral), amitriptyline (Elavil), clomipramine (Anafranil), desipramine (Norpramin), diltiazem (Cardizem, Dilacor), diuretics ('water pills'), flecainide (Tambocor), imipramine (Tofranil), moricizine (ethmozine), nortriptyline (Aventyl, Pamelor), propafenone (Rythmol), propranolol (Inderal), protriptyline (Vivactil), trimipramine (Surmontil), verapamil (Calan, Isoptin), and vitamins. Tell your doctor if you have ever been told you have low magnesium or potassium levels. Tell your doctor if you have or have ever had heart or liver disease. Tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking dolasetron, call your doctor."
American Society of Health-System Pharmacists
7272 Wisconsin Avenue Bethesda, MD 20814
301-657-3000
http://www.safemedication.com/

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Dolasetron, What other drugs will affect dolasetron, Web Md Health:"Do not take dolasetron without first talking to your doctor if you are taking any of the following medicines: a diuretic (water pill) such as furosemide (Lasix), bumetanide (Bumex), torsemide (Demadex), chlorothiazide (Diuril), hydrochlorothiazide (HCTZ, HydroDiuril, Esidrix, Microzide, Oretic), chlorthalidone (Hygroton, Thalitone), indapamide (Lozol), metolazone (Mykrox, Zaroxolyn), amiloride (Midamor), spironolactone (Aldactone, Spironol), triamterene (Dyrenium), and others; a medicine to treat irregular heartbeats such as amiodarone (Cordarone), bepridil (Vascor), disopyramide (Norpace), sotalol (Betapace), and others; cimetidine (Tagamet, Tagamet HB); or rifampin (Rifadin, Rimactane) or rifabutin (Mycobutin).

You may not be able to take dolasetron, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above."
WebMD
1175 Peachtree Road, NE, Suite 2400, Atlanta, GA 30361.
212-624-3700service@webmd.net
http://my.webmd.com/content/drugs/

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