onin syndrome is characterized by rapid development of hyperthermia, hypertension, myoclonus, rigidity, autonomic instability, mental status changes (e.g., delirium or coma), and in rare cases, death. If serotonin syndrome is suspected, discontinue granisetron and concurrent serotonergic agents and initiate appropriate medical treatment. In addition, dolasetron has been associated with a dose-dependent prolongation in the QT, PR, and QRS intervals on an electrocardiogram. Granisetron has a possible risk for QT prolongation and torsade de pointes (TdP) and should be used cautiously and with close monitoring with dolasetron.
Halofantrine: If dolasetron is given with other agents that prolong ECG intervals, particularly the QTc interval; additive effects may be seen. To minimize potential for an interaction, dolasetron should be used cautiously in patients receiving anti-arrhythmic drugs or other drugs known to cause QT prolongation, such as halofantrine.
Halogenated Anesthetics: Halogenated anesthetics should be used cautiously and with close monitoring with dolasetron. Halogenated anesthetics can prolong the QT interval. Dolasetron has been associated with a dose-dependant prolongation in the QT, PR, and QRS intervals on an electrocardiogram. 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 (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.
Haloperidol: Due to a possible risk for QT prolongation and torsade de pointes (TdP), dolasetron and haloperidol should be used together cautiously. Dolasetron has been associated with a dose-dependant prolongation in the QT, PR, and QRS intervals on an electrocardiogram. 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 (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. QT prolongation and torsade de pointes (TdP) have been observed during haloperidol treatment. Excessive doses (particularly in the overdose setting) or IV administration of haloperidol may be associated with a higher risk of QT prolongation. According to the manufacturer of haloperidol, caution is advisable when prescribing the drug concurrently with medications known to prolong the QT interval.
Hydrochlorothiazide, HCTZ; Propranolol: The clearance of hydrodolasetron was decreased by about 27% when dolasetron mesylate injection was administered with atenolol. However, in patients receiving dolasetron concomitantly with propranolol, no effect was observed on the clearance of hydrodolasetron. In addition, dolasetron has been associated with a dose-dependant prolongation in the QT, PR, and QRS intervals on an electrocardiogram. Therefore, drugs such as propranolol, which are known to prolong the PR interval, should be avoided in patients taking dolasetron.
Hydroxychloroquine: Avoid coadministration of hydroxychloroquine and dolasetron. Hydroxychloroquine increases the QT interval and should not be administered with other dru |
