hemotherapy. Patients had a mean age of 8.4 years (range 2 months to 16.9 years) and were 46% male; and 93% white.
The following adverse reactions were reported for palonosetron:
Nervous System: <1%: headache, dizziness, dyskinesia.
General: <1%: infusion site pain.
Dermatological: <1%: allergic dermatitis, skin disorder.
In the trial, adverse reactions were eva luated in pediatric patients receiving palonosetron for up to 4 chemotherapy cycles.
6.2 Postoperative Nausea and VomitingThe adverse reactions cited in Table 2 were reported in ≥ 2% of adults receiving I.V. ALOXI 0.075 mg immediately before induction of anesthesia in one phase 2 and two phase 3 randomized placebo-controlled trials. Rates of events between palonosetron and placebo groups were similar. Some events are known to be associated with, or may be exacerbated by concomitant perioperative and intraoperative medications administered in this surgical population. Please refer to Section 12.2, thorough QT/QTc study results, for data demonstrating the lack of palonosetron effect on QT/QTc.
Table 2: Adverse Reactions from Postoperative Nausea and Vomiting Studies ≥ 2% in any Treatment Group Event ALOXI 0.075
mg
(N=336) Placebo
(N=369)
Electrocardiogram
QT prolongation 16 (5%) 11 (3%)
Bradycardia 13 (4%) 16 (4%)
Headache 11 (3%) 14 (4%)
Constipation 8 (2%) 11 (3%)
In these clinical trials, the following infrequently reported adverse reactions, assessed by investigators as treatment-related or causality unknown, occurred following administration of ALOXI to adult patients receiving concomitant perioperative and intraoperative medications including those associated with anesthesia:
Cardiovascular: 1%: electrocardiogram QTc prolongation, sinus bradycardia, tachycardia, < 1%: blood pressure decreased, hypotension, hypertension, arrhythmia, ventricular extrasystoles, generalized edema, ECG T wave amplitude decreased, platelet count decreased. The frequency of these adverse effects did not appear to be different from placebo.
Dermatological: 1%: pruritus.
Gastrointestinal System: 1%: flatulence, < 1%: dry mouth, upper abdominal pain, salivary hypersecretion, dyspepsia, diarrhea, intestinal hypomotility, anorexia.
General: < 1%: chills.
Liver: 1%: increases in AST and/or ALT, < 1%: hepatic enzyme increased.
Metabolic: < 1%: hypokalemia, anorexia.
Nervous System: < 1%: dizziness.
Respiratory: < 1%: hypoventilation, laryngospasm.
Urinary System: 1%: urinary retention.
6.3 Postmarketing ExperienceThe following adverse reactions have been identified during postapproval use of ALOXI. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.
Very rare cases (<1/10,000) of hypersensitivity reactions including anaphylaxis and anaphylactic shock and injection site reactions (burning, induration, discomfort and pain) were reported from postmarketing experience of ALOXI 0.25 mg in the prevention of chemotherapy-induced nausea and vomiting.
7 DRUG INTERACTIONS
Palonosetron is eliminated from the body th |