Anzemet Injection

1 What is Anzemet Injection?

Brand: Anzemet

Generic: Dolasetron

Anzemet is an antinauseant and antiemetic agent. It is a highly specific selective serotonin subtype 3 (5-HT3) receptor antagonist. This drug works to block the signals to the brain that cause nausea and vomiting.

Anzemet injection is generally used to prevent and treat nausea and vomiting that may happen after surgery or may be caused by chemotherapy or radiation.

This medicine is available only with your doctor's prescription. This product is available in a solution form which is injected to the patients by a nurse or other trained healthcare professionals.

2 What to Know Before Using

Before using Anzemet, you must know all about the risks and complications associated with it. The suitable drug therapy is usually chosen by a doctor with the active participation of the patient.

There are some important factors such as drug interactions, the presence of any metabolic impairment, history of hypersensitivity reaction, pregnancy, lactation etc. that may alter the desired therapeutic effects of a medicine.

Sometimes the presence of other health disorders affects the beneficial effects of this medicine and even may cause serious toxic effects. If you have had any allergic reactions to any medicine then you must tell your doctor about that. The use of dolasetron is contraindicated in patients who are hypersensitive to this drug.

Further, make sure you inform your doctor if you have any other medical problems, especially:

  • Abnormal heart rhythm (e.g. atrial fibrillation, prolonged QT, PR, and QRS interval)
  • Bradycardia (slow heart rate)
  • Congenital long QT syndrome
  • Congestive heart failure
  • Heart block, without a pacemaker—this drug should not be used in patients with these conditions.
  • Sick sinus syndrome—may increase the risk for more serious heart rhythm problems and additional monitoring is required.
  • Hypokalemia (low potassium in the blood)
  • Hypomagnesemia (low magnesium in the blood)—must be corrected first before using this medicine.
  • Kidney disease—patients with these conditions should be monitored with an electrocardiogram (ECG) while using this medicine.

In addition, certain medicines should not be used along with this medicine. It is always recommended to consult with your doctor if you are in need of some other medications or even any over-the-counter medicine for another health problem in order to avoid unwanted toxic effects.

The potential for clinically significant drug interactions posed by dolasetron appears to be low for drugs commonly used in chemotherapy or surgery because dolasetron is eliminated by multiple routes.

Besides, it should be kept in mind the following drug interactions:

  • Blood levels of dolasetron may be increased when it is concurrently administered with cimetidine or other nonselective inhibitors of cytochrome P-450.
  • Blood levels of dolasetron may be decreased when it is simultaneously administered with rifampin or other potent inducers of cytochrome P-450.
  • Clearance of dolasetron may be decreased when it is administered concomitantly with atenolol.
  • The concurrent use of apomorphine must be avoided while undergoing this drug therapy.

Teratology studies over animal have not revealed evidence of impaired fertility or harm to the fetus due to dolasetron. But there are no adequate and well-controlled studies in pregnant women.

Thus, this drug should be used during pregnancy only if clearly needed because animal reproduction studies are not always predictive of human response. Besides, caution is recommended when used in lactating women because many medicines may pass through breast milk.

3 Proper Usage

To use Anzemet properly, you must follow all instructions given by your doctor. The dosage schedule and the duration of drug therapy generally depend on upon the particular medical problem for which you are going to use this medicine. The therapeutic dose may also vary with the patient’s condition or requirement and the strength of the medicine as well.

This medicine is usually given to the patients by a nurse or other trained health professional at your doctor’s chamber, hospital, or clinic. This injection is intended for intravenous. If you want to use this product at home, a health care provider will teach you how to use. However, different dosages for different indications are listed below:

For prevention of cancer chemotherapy-induced nausea and vomiting:

  • Adults –the recommended intravenous dosage of this drug is 1.8 mg/kg given as a single dose approximately 30 minutes before chemotherapy. Alternatively, for most patients, a fixed dose of 100 mg can be administered over 30 seconds.
  • Children –the recommended intravenous dosage in pediatric patients 2 to 16 years of age is 1.8 mg/kg given as a single dose approximately 30 minutes before chemotherapy, up to a maximum of 100 mg. Safety and effectiveness in pediatric patients under 2 years of age have not been established.

For prevention or treatment of postoperative nausea and/or vomiting:

  • Adults –the recommended intravenous dosage is 12.5 mg given as a single dose approximately 15 minutes before the cessation of anesthesia (prevention) or as soon as nausea or vomiting presents (treatment).
  • Children –the recommended intravenous dosage in pediatric patients 2 to 16 years of age is 0.35 mg/kg, with a maximum dose of 12.5 mg, given as a single dose approximately 15 minutes before the cessation of anesthesia or as soon as nausea or vomiting presents. Safety and effectiveness in pediatric patients under 2 years of age have not been established.

If you miss a dose of this medicine, take it as soon as possible. But, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Further, it is advised to store the medicine in a closed container at room temperature away from heat, moisture, and direct light. All kinds of medicines should be kept out of the reach of children. However, outdated medicines should be disposed of by an appropriate way.

4 Precautions to Take

Before using Anzemet, there are some precautions you must take. Firstly, regular visits to your doctor are recommended to check that this medicine is working properly or not.

Additionally, the following guidelines should be followed to prevent unwanted complications as well as for the better prognosis of the patients:

This medicine can cause changes in cardiac rhythms, such as conditions called QT, PR, and QRS prolongation. It may change the way your heart beats and cause fainting or serious side effects in some patients. Contact your doctor right away if you have fast, pounding, or irregular heartbeats.

Anzemet may cause a serious condition called serotonin syndrome if taken together with some medicines such as fentanyl, lithium, MAO inhibitors (e.g. methylene blue), medicine to treat migraine headaches or medicine to treat depression (e.g. fluoxetine, mirtazapine, paroxetine).

Anzemet should be administered with caution in patients who have or may develop prolongation of cardiac conduction intervals because interval prolongation may lead to cardiovascular consequences, including heart block or cardiac arrhythmias.

You should check with your doctor if severe nausea and vomiting continue after leaving the hospital or cancer treatment center.

You should not stop taking this medicine without checking first with your doctor. Your doctor may gradually reduce the amount you are using before stopping completely.

You should not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter) medicines and herbal or vitamin supplements.

5 Potential Side Effects

Make sure you meet with your doctor in using Anzemet to avoid unwanted potential side effects. Along with the beneficial effects, a medicine may cause some unwanted effects (e.g. local pain or burning on IV administration) that may not need any medical attention.

These side effects usually go away during the treatment episode as your body adjusts to the medicine. Your healthcare professional may advise you about the ways how to prevent or reduce those unwanted side effects.

Although dolasetron is well tolerated, sometimes you may need to consult with the doctor if you notice any of the following toxic effects:

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.