peramide has been associated with serious cardiac toxicities, including syncope, ventricular tachycardia, QT prolongation, torsade de pointes (TdP), and cardiac arrest. Dolasetron has also been associated with a dose-dependent prolongation in the QT, PR, and QRS intervals. Use of dolasetron injection for the prevention of chemotherapy-induced nausea and vomiting is contraindicated because the risk of QT prolongation is higher with the doses required for this indication. When the injection is used at lower doses, such as for post-operative nausea and vomiting, or when the oral formulation is used, the risk of QT prolongation is lower and caution is advised.
Loperamide; Simethicone: Use loperamide and dolasetron together with caution. At high doses, loperamide has been associated with serious cardiac toxicities, including syncope, ventricular tachycardia, QT prolongation, torsade de pointes (TdP), and cardiac arrest. Dolasetron has also been associated with a dose-dependent prolongation in the QT, PR, and QRS intervals. Use of dolasetron injection for the prevention of chemotherapy-induced nausea and vomiting is contraindicated because the risk of QT prolongation is higher with the doses required for this indication. When the injection is used at lower doses, such as for post-operative nausea and vomiting, or when the oral formulation is used, the risk of QT prolongation is lower and caution is advised.
Lopinavir; Ritonavir: Due to the potential for QT prolongation and torsade de pointes (TdP), caution is advised when administering lopinavir; ritonavir with dolasetron. Lopinavir; ritonavir is associated with QT prolongation. Dolasetron has also been associated with a dose-dependant prolongation in the QT, PR, and QRS intervals on an electrocardiogram. Use of dolasetron injection for prevention of chemotherapy-induced nausea and vomiting is contraindicated because the risk of QT prolongation is higher with the doses needed for this indication. When the injectable formulation is used at lower doses (i.e., those approved for post-operative nausea and vomiting) or when the oral formulation is used, the risk of QT prolongation is lower and caution is advised. Additionally, lopinavir; ritonavir inhibits CYP3A4 and dolasetron is a CYP3A4 substrate. Coadministation may increase the serum concentrations of dolasetron. The use of ritonavir could result in QT prolongation. Drugs with a possible risk for QT prolongation and TdP that should be used cautiously and with close monitoring with ritonavir include dolasetron.
Luliconazole: Theoretically, luliconazole may increase the side effects of dolasetron, which is a CYP3A4 substrate. Monitor patients for adverse effects of dolasetron, such as QT prolongation. In vitro, therapeutic doses of luliconazole inhibit the activity of CYP3A4 and small systemic concentrations may be noted with topical application, particularly when applied to patients with moderate to severe tinea cruris. No in vivo drug interaction trials were conducted prior to the approval of luliconazole.
Lumacaftor; Ivacaftor: Lumacaftor; ivacaftor may reduce the efficacy of dolasetron by decreasing its systemic exposure. Dolasetron is partially metabolized by CYP3A4. Lumacaftor is a strong inducer of CYP3A. When oral dolasetron was administered with rifampin, another strong CYP3A inducer, for 7 days, the AUC and Cmax of hydrodolasetron decreased by 28% and 17%, respectively. Of note, rifampin is also a weak inducer of CYP2D6, the primary subs |
