tion is used, the risk of QT prolongation is lower and caution is advised. Limited data, including some case reports, suggest that olanzapine may be associated with a significant prolongation of the QTc interval in rare instances. Therefore, caution is advised when administering olanzapine with drugs having an established causal association with QT prolongation and torsade de pointes (TdP).
Ombitasvir; Paritaprevir; Ritonavir: 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.
Ondansetron: These drugs would not be expected to be given together due to therapeutic class duplication; side effects, such as serotonergic actions, may be additive. Ondansetron has been associated with QT prolongation and post-marketing reports of torsade de pointes (TdP). If ondansetron and another drug that prolongs the QT interval must be coadministered, ECG monitoring is recommended. Dolasetron is associated with a lower, but possible risk for QT prolongation and TdP.
Oritavancin: Dolasetron is metabolized by CYP3A4 and CYP2D6; oritavancin is a weak CYP3A4 and CYP2D6 inducer. Plasma concentrations and efficacy of dolasetron may be reduced if these drugs are administered concurrently.
Osimertinib: Use caution if coadministration of osimertinib with dolasetron is necessary, and closely monitor for possible QT prolongation. Osimertinib causes concentration dependent prolongation of the QT interval at recommended dosing. Dolasetron has been associated with a dose-dependent prolongation in the QT, PR, and QRS intervals on an electrocardiogram. Additive QT prolongation is possible. 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.
Oxaliplatin: Use caution if coadministration of oxaliplatin with dolasetron is necessary, and closely monitor for possible QT prolongation. QT prolongation and ventricular arrhythmias including fatal torsade de pointes have been reported with oxaliplatin use in post-marketing experience. Dolasetron has also been associated with a dose-dependent prolongation in the QT, PR, and QRS intervals on an electrocardiogram. Additive QT prolongation is possible.
Oxycodone: Serotonin syndrome can occur during concomitant use of opiate agonists with serotonergic drugs, such as serotonin-receptor antagonists. Symptoms may occur hours to days after concomitant use, particularly after dose increases. Serotonin syndrome may occur within recommended dose ranges. If concomitant treatment is clinically warranted, careful observation of the patient is advised, especially during initiation of the second therapy and after dosage increases of either agent. Instruct patients to immediately report symptoms of agitation, hallucinations, tachycardia, fever, excessive sweating, shivering or shaking, muscle twitching or stiffness, trouble with coordination, nausea, vomiting, or diarrhea.
Paliperidone: Due to a possible risk for QT prolongation and torsade de pointes (TdP), dolasetron and paliperidone should be used together cautiously. Dolasetron h |
