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Anzemet
Anzemet (dolasetron) is a prescription antiemetic medication used to prevent and treat nausea and vomiting caused by chemotherapy, radiation therapy, and surgery. It belongs to the 5-HT3 receptor antagonists class, which works by blocking serotonin, a chemical in the body that can trigger vomiting. Anzemet is particularly effective in managing nausea and vomiting associated with cancer treatments, making it an important part of supportive care for patients undergoing chemotherapy.
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Frequently Asked Questions
How quickly does Anzemet start working?
Anzemet typically begins working within 30 to 60 minutes after oral administration, making it effective for preventing nausea and vomiting when taken before chemotherapy or surgery.
Can I take Anzemet with other anti-nausea medications?
Yes, Anzemet is often used in combination with other anti-nausea medications, such as corticosteroids or NK1 receptor antagonists, to improve its effectiveness. Always consult your doctor before combining medications.
What should I do if I miss a dose of Anzemet?
If you miss a dose of Anzemet before chemotherapy or surgery, contact your healthcare provider for advice. It is important to take the medication at the right time to prevent nausea.
Is Anzemet safe during pregnancy?
Anzemet should only be used during pregnancy if clearly needed and prescribed by your healthcare provider. There is limited data on its use during pregnancy, so weigh the risks and benefits with your doctor.
Can Anzemet cause heart problems?
Yes, Anzemet can cause QT prolongation, which may lead to serious heart rhythm problems. Patients with a history of heart disease or electrolyte imbalances should be monitored closely while taking this medication.
Comprehensive Drug Guide
How Does Anzemet Work?
Anzemet works by blocking 5-hydroxytryptamine (5-HT3) receptors, which are involved in the vomiting reflex. By inhibiting the action of serotonin on these receptors in the gastrointestinal tract and brain, Anzemet helps prevent nausea and vomiting, particularly those triggered by chemotherapy or surgery.
Common Dosages
- Tablets: 50 mg, 100 mg
- Intravenous (IV) formulation: Typically administered by a healthcare provider
Typical Dosing
- For chemotherapy-induced nausea and vomiting: The usual adult dose is 100 mg orally given within 1 hour before chemotherapy.
- For postoperative nausea and vomiting: The typical dose is 12.5 mg IV given about 15 minutes before the end of surgery. Alternatively, oral dosing can be used when appropriate.
- Pediatric dosing is based on weight, typically at 1.8 mg/kg (up to a maximum of 100 mg) for chemotherapy prevention.
Typical Dosing
FDA Approved Indications
- Prevention of nausea and vomiting associated with chemotherapy in adults and children.
- Prevention and treatment of postoperative nausea and vomiting.
Who Shouldn't Take Anzemet?
- Congenital long QT syndrome (as it can prolong the QT interval, increasing the risk of arrhythmias)
- Known hypersensitivity to dolasetron or any other component of the formulation
- Severe heart rhythm disorders, unless under strict medical supervision
Advice From The Pharmacist
- Take Anzemet exactly as prescribed by your doctor, especially timing it properly before chemotherapy or surgery.
- Avoid using Anzemet tablets for the treatment of nausea after surgery due to an increased risk of heart rhythm complications. Intravenous use is preferred in this case.
- If you are prone to heart rhythm issues, inform your doctor, as Anzemet can affect QT prolongation.
- Report any signs of an irregular heartbeat, such as palpitations or dizziness, immediately.
Side Effects of Anzemet
Common Side Effects
- Headache
- Dizziness
- Fatigue
Uncommon/Severe Side Effects
- QT prolongation (a serious heart rhythm condition)
- Arrhythmias
- Severe allergic reactions (swelling, rash, difficulty breathing)
Risks and Warnings of Anzemet
- QT Prolongation and Cardiac Risk: Anzemet can cause QT prolongation, which may lead to serious and potentially fatal heart arrhythmias, especially in those with existing heart conditions or electrolyte imbalances. Monitoring of heart rhythm is necessary in at-risk patients.
- Use in Children: Anzemet should be used with caution in children, particularly those who may be more susceptible to heart-related side effects.
- Postoperative Use: The FDA has issued warnings against using oral Anzemet for postoperative nausea and vomiting due to the risk of heart-related side effects.
Interactions with Anzemet
Common Drug Interactions
- Antiarrhythmic drugs: Combining Anzemet with medications that affect the heart's electrical activity (e.g., amiodarone, sotalol) may increase the risk of arrhythmias.
- Antidepressants: Certain antidepressants (e.g., SSRIs, SNRIs) can increase the risk of serotonin syndrome when used with Anzemet.
- Diuretics: Diuretics that affect electrolyte balance (e.g., furosemide) can increase the risk of QT prolongation when used with Anzemet.
Alternatives to Anzemet
- Zofran (ondansetron): Another 5-HT3 antagonist often used for nausea and vomiting related to chemotherapy, radiation, and surgery.
- Aloxi (palonosetron): A longer-acting 5-HT3 antagonist used for nausea and vomiting associated with chemotherapy.
- Emend (aprepitant): A NK1 receptor antagonist that is sometimes combined with 5-HT3 antagonists like Anzemet to provide more complete nausea control.
- Metoclopramide: An antiemetic that works through dopamine antagonism, used for nausea associated with various conditions, including chemotherapy.
