Dolasetron

(dohl-ah-se-tron)

Trade/other name(s): Anzemet

Why would this drug be used?

Dolasetron is used to prevent nausea and vomiting from chemotherapy. It is also used to prevent nausea and vomiting after surgery.

How does this drug work?

Dolasetron is part of a general class of drugs called serotonin antagonists. These drugs block the serotonin pathway by which the vomiting center in the brain is stimulated.

Before taking this medicine

Tell your doctor…

• If you are allergic to anything, including medicines, dyes, additives, or foods.
• If you have an abnormal heart rhythm, slow heartbeat, heart block, prolonged Q-T interval, or any problem with the heart's electrical system. Dolasetron can slow down the heart's electrical impulses and make these problems worse.
• If you have low potassium or low magnesium levels or if you are taking medicines such as diuretics ("water pills") that may affect levels of those minerals. Dolasetron can slow down the heart's electrical impulses; lower levels of potassium and magnesium can make the situation more dangerous.
• If you have heart failure, atrial fibrillation, angina, or poor kidney function.
• If you have taken chemotherapy drugs that can damage the heart, such as daunorubicin, doxorubicin, epirubicin, or idarubicin. These medicines may worsen the effects on the heart.
• If you are pregnant, trying to get pregnant, or if there is any chance of pregnancy. Even though tests did not show any damage in pregnant animals, dolasetron has not been tested in pregnant women.
• If you are breast-feeding. It is not known whether this drug passes into breast milk. If it does, it could affect the baby.
• About any other prescription or over-the-counter medicines you are taking, including vitamins and herbs. In fact, keeping a written list of each of these medicines (including the doses of each and when you take them) with you in case of emergency may help prevent complications if you get sick.

Interactions with other drugs

Medicines that make you urinate more (diuretics or "water pills") may worsen electrical problems with the heart by lowering your potassium and magnesium levels. Other blood pressure medicines such as verapamil can worsen heart problems as well.

These drugs can increase your risk of abnormal heart rhythm if you take them during the same times you take dolasetron

• heart rhythm drugs such as amiodorone (Cordarone, Pacerone), disopyramide (Norpace), dofetilide (Tikosyn), flecainide (Rhythmol), ibutilide (Corvert), procainamide (Procan, Pronestyl), propafenone (Tambocor), quinidine (Quinidex, Cardioquin), or sotalol (Betapace)
• anti-psychotic drugs such as thioridazine (Mellaril), haloperidol (Haldol), mesoridazine (Serentil)
• antidepressants such as venlafaxine (Effexor) and amitriptyline (Elavil)
• certain antibiotics (e.g., erythromycin, clarithromycin, levofloxacin, ofloxacin, moxifloxacin, sparfloxacin, pentamidine)

Do not use this drug if you take apomorphine (Apokyn) for Parkinson's disease.

Cimetidine (Tagamet) can raise the level of dolasetron in the blood which increases the risk of dolasetron side effects, including heart problems.

Rifampin can cause the body to get rid of dolasetron faster so that it doesn’t work as well.

Talk to your doctor or pharmacist about which drugs you are taking that might affect the heart's electrical system. Check with your doctor, nurse, or pharmacist about whether any of the medicines, vitamins, herbs, and supplements you are taking can cause other problems with this medicine.

Interactions with foods

No serious interactions with food are known at this time. Check with your doctor, nurse, or pharmacist about whether foods may be a problem.

Tell all the doctors, dentists, nurses, and pharmacists you visit that you are taking this drug.

How is this drug taken or given?

Dolasetron can be given by mouth as a tablet or as an injection into the vein over 1 to 15 minutes. It is typically given 30 minutes to 2 hours before surgery. The dose is either standard or based on your weight.

Take this drug exactly as specified by your doctor. If you do not understand the label or directions, ask your doctor or nurse to explain them to you.

Store this medicine away from heat and light, out of the reach of children and pets.

Precautions

Call your doctor right away if you have a slow or irregular heartbeat, or if you feel dizzy, faint, or light headed. This is more likely to happen if you get the drug in your vein rather than by mouth, but it can happen with either form of the medicine. Your doctor may monitor your heart rhythm by using an EKG during treatment with this medicine.

Although rare, this drug can cause severe allergic reaction known as anaphylaxis. If you notice hives (skin welts), itching, dizziness, trouble breathing or swallowing, or swelling of the face, eyes, or mouth, get emergency help.

Possible side effects

You will probably not have most of the following side effects, but if you have any talk to your doctor or nurse. They can help you understand the side effects and cope with them.

Less common

• headache

Rare

• fever
• tiredness (fatigue)
• bone pain
• muscle aches
• constipation
• heartburn
• loss of appetite
• inflammation of the pancreas
• changes in electrical impulses in the heart*
• low blood pressure
• dizziness
• slow or fast heart rate*
• flushing
• vivid dreams
• sleep problems
• confusion
• anxiety
• severe allergic reaction, with symptoms such as itching, swelling in the face, dizziness, trouble breathing or swallowing*
• death due to abnormal heart rhythm or cardiac arrest

*See "Precautions" section for more detailed information.

There are some other side effects not listed above that can also occur in some patients. Tell your doctor or nurse if you develop these or any other problems.

FDA approval

Yes – first approved in 1997.

Disclaimer: This information does not cover all possible uses, actions, precautions, side effects, or interactions. It is not intended as medical advice, and should not be relied upon as a substitute for talking with your doctor, who is familiar with your medical needs.