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Dolasetron

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Dolasetron, Anzemet

  • See Also
  1. 5-HT3 Antagonist
  2. Ondansetron
  3. Palonosetron
  4. Granisetron
  5. Nausea in Cancer
  • Indications
  1. Chemotherapy associated Nausea
  2. Radiation Therapy associated Nausea
  3. Perioperative Nausea and Vomiting
  • Contraindications
  1. QTc Prolongation
  • Mechanism
  1. Blocks peripheral and central 5HT3 receptors
    1. Peripheral 5HT3 receptors at vagal nerve terminals
    2. Central 5HT3 receptors at ChemoreceptorTrigger Zone in Medulla (area postrema controls Vomiting)
  • Adverse Effects
  1. See 5-HT3 Antagonist
  2. QTc Prolongation (Ondansetron, Dolasetron)
    1. See Ondansetron
    2. Higher risk in higher doses, preexisting QTc Prolongation, CHF, Bradycardia, Hypomagnesemia, Hypokalemia
  3. Serotonin Syndrome
    1. http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Surveillance/AdverseDrugEffects/ucm351864.htm
  • Dosing
  1. Nausea with Chemotherapy
    1. Adult 100 mg orally given 60 minutes before Chemotherapy
    2. Child age 2 to 16 years: 1.8 mg/kg for single dose up to 100 mg orally given 60 minutes before Chemotherapy
  2. Prevention of Surgery Related Nausea (Preoperative)
    1. Given perioperatively for prevention of Nausea or Vomiting
    2. Adult: 100 mg orally taken 2 hours before surgery
    3. Child age 2 to 16 years: 1.2 mg/kg up to 100 mg orally 2 hours before surgery
  3. Surgery Related Nausea or Vomiting (Postoperative)
    1. Given prophylactically 15 min before Anesthesia ends to prevent Postoperative Nausea and Vomiting
    2. Adult: 12.5 mg IV for single dose given 15 minutes before end of Anesthesia
    3. Child: 0.35 mg/kg up to 12.5 mg IV for single dose before end of Anesthesia
  • Drug Interactions
  1. Cimetidine increases Dolasetron serum levels
  2. Rifampin decreases Dolasetron serum levels
  • Safety
  1. Pregnancy Category B
  2. Unknown safety in Lactation
  • Resources
  1. Dolasetron (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=201b0eb8-4a1e-4e22-ab4b-addb642710d6
  • References
  1. Hamilton (2020) Tarascon Pocket Pharmacopoeia
  2. Meyer (2005) Anesth Analg 100(2):373-7 +PMID: 15673860 [PubMed]
  3. Balfour (1997) Drugs 54(2):273-98 +PMID: 9257083 [PubMed]