Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 20mg/mL
tablet
- 50mg
- 100mg
Cancer Chemotherapy Induced Nausea & Vomiting
Oral: 100 mg PO 1 hr before chemotherapy
Note: IV administration no longer indicated for CINV because of risk for QT prolongation
Post-op Nausea & Vomiting
Indicated for prevention and treatment of postoperative nausea and vomiting (PONV)
IV: 12.5 mg IV 15 minutes before cessation of anesthesia or as soon as N/V presents
Note: Oral tablet no longer indicated for PONV
Dosing considerations
Post-op nausea & vomiting
- As with other antiemetics, routine prophylaxis is not recommended for patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively
- In patients where nausea and/or vomiting must be avoided postoperatively, a 5-HT3 receptor antagonist is recommended even where the incidence of postoperative nausea and/or vomiting is low
- When prophylaxis has failed, a repeat dose should not be initiated as rescue therapy
Dosage Forms & Strengths
injectable solution
- 20mg/mL
tablet
- 50mg
- 100mg
Cancer Chemotherapy Induced Nausea & Vomiting
<2 years: Safety and efficacy not established
2-16 years: 1.8 mg/kg PO 1 hr before chemotherapy; not to exceed 100 mg/dose
IV may be administered PO in children aged 2-16 years: 1.8 mg/kg PO 1 hr before chemotherapy; not to exceed 100 mg/dose
Note: IV administration no longer indicated for CINV because of risk for QT prolongation
Postoperative Nausea & Vomiting
Indicated for prevention and treatment of post-op nausea and vomiting (PONV) in children ≥2 years
<2 years: Safety and efficacy not established
IV: 0.35 mg/kg 15 minutes before cessation of anesthesia or as soon as N/V develops; not to exceed 12.5 mg/dose
IV may be administered PO in children aged 2-16 years: 1.2 mg/kg PO administered within 2 hr before surgery; not to exceed 100 mg/dose
Note: Oral tablet no longer indicated for PONV
Dosing considerations
Post-op nausea & vomiting
- As with other antiemetics, routine prophylaxis is not recommended for patients in whom there is little expectation that nausea and/or vomiting will occur postoperatively
- In patients where nausea and/or vomiting must be avoided postoperatively, a 5-HT3 receptor antagonist is recommended even where the incidence of postoperative nausea and/or vomiting is low
- When prophylaxis has failed, a repeat dose should not be initiated as rescue therapy
Administration
IV administered PO
- Injectable solution may be given PO mixed in apple-grape or apple juice
- Diluted product may be kept up to 2 hr at room temperature
Cancer chemotherapy induced nausea & vomiting
Oral: 100 mg PO 1 hr before chemotherapy
Note: IV administration no longer indicated for CINV because of risk for QT prolongation
Post-op nausea & vomiting
IV: 12.5 mg IV 15 minutes before cessation of anesthesia or as soon as N/V presents
Note: Oral tablet no longer indicated for PONV
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- apomorphine
apomorphine, dolasetron. Mechanism: unspecified interaction mechanism. Contraindicated. Profound hypotension and loss of consciousness reported when 5HT3 antagonists are coadministered with apomorphine. Additionally, dolasetron may cause additive QT prolongation with apomorphine.
dolasetron and apomorphine both increase QTc interval. Contraindicated.
Serious - Use Alternative (88)
- adagrasib
adagrasib, dolasetron. Either increases effects of the other by QTc interval. Avoid or Use Alternate Drug. Each drug prolongs the QTc interval, which may increased the risk of Torsade de pointes, other serious arryhthmias, and sudden death. If coadministration unavoidable, more frequent monitoring is recommended for such patients.
- almotriptan
dolasetron, almotriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- amiodarone
amiodarone and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- amisulpride
amisulpride and dolasetron both increase QTc interval. Avoid or Use Alternate Drug. ECG monitoring is recommended if coadministered.
- amitriptyline
dolasetron, amitriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- amoxapine
dolasetron, amoxapine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- anagrelide
dolasetron and anagrelide both increase QTc interval. Avoid or Use Alternate Drug.
- arsenic trioxide
arsenic trioxide and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- artemether
artemether and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- asenapine
dolasetron and asenapine both decrease QTc interval. Avoid or Use Alternate Drug.
- asenapine transdermal
asenapine transdermal and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine
dolasetron and buprenorphine both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine buccal
buprenorphine buccal and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine subdermal implant
buprenorphine subdermal implant and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine transdermal
buprenorphine transdermal and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- buprenorphine, long-acting injection
buprenorphine, long-acting injection and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- ceritinib
ceritinib and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- citalopram
dolasetron, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- clomipramine
dolasetron, clomipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- desflurane
desflurane and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- desipramine
dolasetron, desipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- desvenlafaxine
dolasetron, desvenlafaxine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- disopyramide
disopyramide and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- doxepin
dolasetron, doxepin. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- duloxetine
dolasetron, duloxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- eletriptan
dolasetron, eletriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- encorafenib
dolasetron and encorafenib both increase QTc interval. Avoid or Use Alternate Drug.
- entrectinib
dolasetron and entrectinib both increase QTc interval. Avoid or Use Alternate Drug.
- eribulin
eribulin and dolasetron both increase QTc interval. Avoid or Use Alternate Drug. Potential for enhanced QTc-prolonging effects; if concurrent use is necessary then ECG monitoring is recommended.
- fexinidazole
fexinidazole and dolasetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of fexinidazole with drugs known to block potassium channels or prolong QT interval.
- fluoxetine
dolasetron, fluoxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- fluvoxamine
fluvoxamine and dolasetron both increase serotonin levels. Avoid or Use Alternate Drug.
- frovatriptan
dolasetron, frovatriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- glasdegib
dolasetron and glasdegib both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, monitor for increased risk of QTc interval prolongation.
- hydroxychloroquine sulfate
hydroxychloroquine sulfate and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- ibutilide
dolasetron and ibutilide both increase QTc interval. Avoid or Use Alternate Drug.
- imipramine
dolasetron, imipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- indapamide
dolasetron and indapamide both increase QTc interval. Avoid or Use Alternate Drug.
- inotuzumab
inotuzumab and dolasetron both increase QTc interval. Avoid or Use Alternate Drug. If unable to avoid concomitant use, obtain ECGs and electrolytes before and after initiation of any drug known to prolong QTc, and periodically monitor as clinically indicated during treatment.
- isocarboxazid
dolasetron, isocarboxazid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- isoflurane
dolasetron and isoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- ivosidenib
ivosidenib and dolasetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid coadministration of QTc prolonging drugs with ivosidenib or replace with alternate therapies. If coadministration of a QTc prolonging drug is unavoidable, monitor for increased risk of QTc interval prolongation.
- lefamulin
lefamulin and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- levomilnacipran
dolasetron, levomilnacipran. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- lofexidine
dolasetron and lofexidine both increase QTc interval. Avoid or Use Alternate Drug.
- lopinavir
dolasetron and lopinavir both increase QTc interval. Avoid or Use Alternate Drug.
- macimorelin
macimorelin and dolasetron both increase QTc interval. Avoid or Use Alternate Drug. Macimorelin causes an increase of ~11 msec in the corrected QT interval. Avoid coadministration with drugs that prolong QT interval, which could increase risk for developing torsade de pointes-type ventricular tachycardia. Allow sufficient washout time of drugs that are known to prolong the QT interval before administering macimorelin.
- midostaurin
dolasetron and midostaurin both increase QTc interval. Avoid or Use Alternate Drug.
- milnacipran
dolasetron, milnacipran. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- mobocertinib
mobocertinib and dolasetron both increase QTc interval. Avoid or Use Alternate Drug. If coadministration unavoidable, reduce mobocertinib dose and monitor QTc interval more frequently.
- naratriptan
dolasetron, naratriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- nortriptyline
dolasetron, nortriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- ondansetron
dolasetron and ondansetron both increase QTc interval. Avoid or Use Alternate Drug. Avoid with congenital long QT syndrome; ECG monitoring recommended with concomitant medications that prolong QT interval, electrolyte abnormalities, CHF, or bradyarrhythmias.
- oxaliplatin
dolasetron and oxaliplatin both increase QTc interval. Avoid or Use Alternate Drug.
- paroxetine
dolasetron, paroxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- pentamidine
dolasetron and pentamidine both increase QTc interval. Avoid or Use Alternate Drug.
- phenelzine
dolasetron, phenelzine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- pimavanserin
dolasetron and pimavanserin both increase QTc interval. Avoid or Use Alternate Drug.
- pimozide
dolasetron and pimozide both increase QTc interval. Avoid or Use Alternate Drug.
- pitolisant
dolasetron and pitolisant both increase QTc interval. Avoid or Use Alternate Drug.
- ponesimod
dolasetron and ponesimod both increase QTc interval. Avoid or Use Alternate Drug.
- procainamide
dolasetron and procainamide both increase QTc interval. Avoid or Use Alternate Drug.
- propafenone
dolasetron and propafenone both increase QTc interval. Avoid or Use Alternate Drug.
- protriptyline
dolasetron, protriptyline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- quinidine
quinidine and dolasetron both increase QTc interval. Avoid or Use Alternate Drug.
- rasagiline
dolasetron, rasagiline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- ribociclib
ribociclib increases toxicity of dolasetron by QTc interval. Avoid or Use Alternate Drug.
- rizatriptan
dolasetron, rizatriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- romidepsin
dolasetron and romidepsin both increase QTc interval. Avoid or Use Alternate Drug.
- selegiline
dolasetron, selegiline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- selegiline transdermal
dolasetron, selegiline transdermal. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- sertraline
dolasetron, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- sevoflurane
dolasetron and sevoflurane both increase QTc interval. Avoid or Use Alternate Drug.
- siponimod
dolasetron and siponimod both increase QTc interval. Avoid or Use Alternate Drug.
- sotalol
dolasetron and sotalol both increase QTc interval. Avoid or Use Alternate Drug.
- sumatriptan
dolasetron, sumatriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- sumatriptan intranasal
dolasetron, sumatriptan intranasal. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- tedizolid
tedizolid, dolasetron. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.
- tetrabenazine
dolasetron and tetrabenazine both increase QTc interval. Avoid or Use Alternate Drug.
- toremifene
dolasetron and toremifene both increase QTc interval. Avoid or Use Alternate Drug. Concurrent use of toremifene with agents causing QT prolongation should be avoided. If concomitant use is required it's recommended that toremifene be interrupted. If interruption not possible, patients requiring therapy with a drug that prolongs QT should be closely monitored. ECGs should be obtained for high risk patients.
- tranylcypromine
dolasetron, tranylcypromine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- trimipramine
dolasetron, trimipramine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- umeclidinium bromide/vilanterol inhaled
dolasetron increases toxicity of umeclidinium bromide/vilanterol inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- vandetanib
dolasetron, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.
- vemurafenib
vemurafenib and dolasetron both increase QTc interval. Avoid or Use Alternate Drug. Concomitant use of vemurafenib with drugs that prolong QT interval is not recommended.
- venlafaxine
dolasetron, venlafaxine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- vilanterol/fluticasone furoate inhaled
dolasetron increases toxicity of vilanterol/fluticasone furoate inhaled by QTc interval. Avoid or Use Alternate Drug. Exercise extreme caution when vilanterol coadministered with drugs that prolong QTc interval; adrenergic agonist effects on the cardiovascular system may be potentiated.
- zolmitriptan
dolasetron, zolmitriptan. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (130)
- albuterol
albuterol and dolasetron both increase QTc interval. Use Caution/Monitor.
- alfuzosin
dolasetron and alfuzosin both increase QTc interval. Use Caution/Monitor.
alfuzosin and dolasetron both increase QTc interval. Use Caution/Monitor. - amitriptyline
amitriptyline and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- amoxapine
amoxapine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- arformoterol
arformoterol and dolasetron both increase QTc interval. Use Caution/Monitor.
- aripiprazole
aripiprazole and dolasetron both increase QTc interval. Use Caution/Monitor.
- artemether/lumefantrine
dolasetron and artemether/lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.
- atazanavir
atazanavir increases levels of dolasetron by QTc interval. Modify Therapy/Monitor Closely. Potential for increased toxicity. Use alternatives if available. Increased risk of cardiac arrhythmias.
- atomoxetine
atomoxetine and dolasetron both increase QTc interval. Use Caution/Monitor.
- bedaquiline
dolasetron and bedaquiline both increase QTc interval. Modify Therapy/Monitor Closely. ECG should be monitored closely
- chloroquine
chloroquine increases toxicity of dolasetron by QTc interval. Use Caution/Monitor.
- chlorpromazine
chlorpromazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- ciprofloxacin
ciprofloxacin and dolasetron both increase QTc interval. Use Caution/Monitor. Ciprofloxacin elicits minimal effects on QT interval. Caution if used in combination with other drugs known to affect QT interval or in patients with other risk factors.
- cisapride
dolasetron and cisapride both increase QTc interval. Use Caution/Monitor.
- citalopram
dolasetron and citalopram both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- clarithromycin
clarithromycin and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- clomipramine
clomipramine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- clozapine
clozapine and dolasetron both increase QTc interval. Use Caution/Monitor.
- crizotinib
crizotinib and dolasetron both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
- dasatinib
dasatinib and dolasetron both increase QTc interval. Use Caution/Monitor.
- degarelix
degarelix and dolasetron both increase QTc interval. Use Caution/Monitor.
- desipramine
desipramine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- deutetrabenazine
deutetrabenazine and dolasetron both increase QTc interval. Use Caution/Monitor. At the maximum recommended dose, deutetrabenazine does not prolong QT interval to a clinically relevant extent. Certain circumstances may increase risk of torsade de pointes and/or sudden death in association with drugs that prolong the QTc interval (eg, bradycardia, hypokalemia or hypomagnesemia, coadministration with other drugs that prolong QTc interval, presence of congenital QT prolongation).
- dofetilide
dofetilide and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- donepezil
donepezil and dolasetron both increase QTc interval. Use Caution/Monitor.
- doxepin
doxepin and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- dronedarone
dolasetron and dronedarone both increase QTc interval. Modify Therapy/Monitor Closely.
- droperidol
dolasetron and droperidol both increase QTc interval. Modify Therapy/Monitor Closely.
- efavirenz
efavirenz and dolasetron both increase QTc interval. Use Caution/Monitor.
- eliglustat
dolasetron and eliglustat both increase QTc interval. Use Caution/Monitor.
- epinephrine
epinephrine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- epinephrine racemic
epinephrine racemic and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- erythromycin base
dolasetron and erythromycin base both increase QTc interval. Modify Therapy/Monitor Closely.
- erythromycin ethylsuccinate
dolasetron and erythromycin ethylsuccinate both increase QTc interval. Modify Therapy/Monitor Closely.
- erythromycin lactobionate
dolasetron and erythromycin lactobionate both increase QTc interval. Modify Therapy/Monitor Closely.
- erythromycin stearate
dolasetron and erythromycin stearate both increase QTc interval. Modify Therapy/Monitor Closely.
- escitalopram
dolasetron, escitalopram. Either increases toxicity of the other by serotonin levels. Use Caution/Monitor. Monitor ECG, symptoms of serotonin syndrome especially during initiation/titration.
escitalopram increases toxicity of dolasetron by QTc interval. Use Caution/Monitor. - ezogabine
ezogabine, dolasetron. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Slight and transient QT-prolongation observed with ezogabine, particularly when dose titrated to 1200 mg/day. QT interval should be monitored when ezogabine is prescribed with agents known to increase QT interval.
- fenfluramine
dolasetron decreases effects of fenfluramine by pharmacodynamic antagonism. Use Caution/Monitor. Potent serotonin receptor antagonists may decrease fenfluramine efficacy. If coadministered, monitor appropriately.
- fingolimod
fingolimod and dolasetron both increase QTc interval. Use Caution/Monitor.
- flecainide
dolasetron and flecainide both increase QTc interval. Use Caution/Monitor.
- fluconazole
dolasetron and fluconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- fluoxetine
dolasetron and fluoxetine both increase QTc interval. Use Caution/Monitor.
- fluphenazine
fluphenazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- fluvoxamine
fluvoxamine and dolasetron both increase QTc interval. Use Caution/Monitor.
- formoterol
dolasetron and formoterol both increase QTc interval. Modify Therapy/Monitor Closely.
- foscarnet
dolasetron and foscarnet both increase QTc interval. Use Caution/Monitor.
- fostemsavir
dolasetron and fostemsavir both increase QTc interval. Use Caution/Monitor. QTc prolongation reported with higher than recommended doses of fostemsavir.
- gemifloxacin
dolasetron and gemifloxacin both increase QTc interval. Use Caution/Monitor.
- gemtuzumab
dolasetron and gemtuzumab both increase QTc interval. Use Caution/Monitor.
- gilteritinib
dolasetron and gilteritinib both increase QTc interval. Use Caution/Monitor.
- goserelin
goserelin increases toxicity of dolasetron by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- granisetron
dolasetron and granisetron both increase QTc interval. Use Caution/Monitor.
- haloperidol
dolasetron and haloperidol both increase QTc interval. Modify Therapy/Monitor Closely.
- histrelin
histrelin increases toxicity of dolasetron by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- hydroxyzine
dolasetron and hydroxyzine both increase QTc interval. Use Caution/Monitor.
- iloperidone
dolasetron and iloperidone both increase QTc interval. Use Caution/Monitor.
- imipramine
imipramine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- indacaterol, inhaled
indacaterol, inhaled, dolasetron. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.
- itraconazole
dolasetron and itraconazole both increase QTc interval. Use Caution/Monitor.
- ketoconazole
dolasetron and ketoconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- lapatinib
dolasetron and lapatinib both increase QTc interval. Use Caution/Monitor.
- lenvatinib
dolasetron and lenvatinib both increase QTc interval. Use Caution/Monitor. Lenvatinib prescribing information recommends monitoring ECG closely when coadministered with QT prolonging drugs.
- letermovir
letermovir increases levels of dolasetron by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor.
- leuprolide
leuprolide increases toxicity of dolasetron by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- levalbuterol
dolasetron and levalbuterol both increase QTc interval. Use Caution/Monitor.
- levofloxacin
dolasetron and levofloxacin both increase QTc interval. Use Caution/Monitor.
- levoketoconazole
dolasetron and levoketoconazole both increase QTc interval. Modify Therapy/Monitor Closely.
- lithium
dolasetron and lithium both increase QTc interval. Use Caution/Monitor.
- lofepramine
lofepramine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- loperamide
dolasetron and loperamide both increase QTc interval. Use Caution/Monitor.
- lumefantrine
dolasetron and lumefantrine both increase QTc interval. Modify Therapy/Monitor Closely.
- maprotiline
maprotiline and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- mefloquine
dolasetron and mefloquine both increase QTc interval. Use Caution/Monitor.
- methadone
dolasetron and methadone both increase QTc interval. Use Caution/Monitor.
- mifepristone
mifepristone, dolasetron. QTc interval. Modify Therapy/Monitor Closely. Use alternatives if available.
- mirtazapine
dolasetron and mirtazapine both increase QTc interval. Use Caution/Monitor.
- moxifloxacin
dolasetron and moxifloxacin both increase QTc interval. Modify Therapy/Monitor Closely.
- nilotinib
dolasetron and nilotinib both increase QTc interval. Modify Therapy/Monitor Closely.
- nortriptyline
nortriptyline and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- octreotide
dolasetron and octreotide both increase QTc interval. Modify Therapy/Monitor Closely.
- octreotide (Antidote)
dolasetron and octreotide (Antidote) both increase QTc interval. Modify Therapy/Monitor Closely.
- ofloxacin
dolasetron and ofloxacin both increase QTc interval. Use Caution/Monitor.
- olanzapine
dolasetron and olanzapine both increase QTc interval. Use Caution/Monitor.
- olodaterol inhaled
dolasetron and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias
- osilodrostat
osilodrostat and dolasetron both increase QTc interval. Use Caution/Monitor.
- osimertinib
osimertinib and dolasetron both increase QTc interval. Use Caution/Monitor. Conduct periodic monitoring with ECGs and electrolytes in patients taking drugs known to prolong the QTc interval.
- oxaliplatin
oxaliplatin will increase the level or effect of dolasetron by Other (see comment). Use Caution/Monitor. Monitor for ECG changes if therapy is initiated in patients with drugs known to prolong QT interval.
- ozanimod
ozanimod and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely. The potential additive effects on heart rate, treatment with ozanimod should generally not be initiated in patients who are concurrently treated with QT prolonging drugs with known arrhythmogenic properties.
- paliperidone
dolasetron and paliperidone both increase QTc interval. Use Caution/Monitor.
- panobinostat
dolasetron and panobinostat both increase QTc interval. Modify Therapy/Monitor Closely. Panobinostat is known to significantly prolong QT interval. Panobinostat prescribing information states use with drugs known to prolong QTc is not recommended; however, antiemetic drugs known to prolong QTc (eg, dolasetron, granisetron, ondansetron) can be used with frequent ECG monitoring.
- paroxetine
dolasetron and paroxetine both increase QTc interval. Use Caution/Monitor.
- pasireotide
dolasetron and pasireotide both increase QTc interval. Modify Therapy/Monitor Closely.
- perphenazine
perphenazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- posaconazole
dolasetron and posaconazole both increase QTc interval. Use Caution/Monitor.
- primaquine
dolasetron and primaquine both increase QTc interval. Use Caution/Monitor.
- prochlorperazine
prochlorperazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- promazine
promazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- promethazine
promethazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- protriptyline
protriptyline and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- quetiapine
quetiapine, dolasetron. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.
- quinine
dolasetron and quinine both increase QTc interval. Use Caution/Monitor.
- ranolazine
dolasetron and ranolazine both increase QTc interval. Use Caution/Monitor.
- rilpivirine
rilpivirine increases toxicity of dolasetron by QTc interval. Use Caution/Monitor. Rilpivirine should be used with caution when co-administered with a drug with a known risk of Torsades de Pointes.
- risperidone
dolasetron and risperidone both increase QTc interval. Use Caution/Monitor.
- salmeterol
dolasetron and salmeterol both increase QTc interval. Use Caution/Monitor.
- saquinavir
saquinavir increases levels of dolasetron by QTc interval. Modify Therapy/Monitor Closely. Potential for increased toxicity. Increased risk of cardiac arrhythmias.
- selpercatinib
selpercatinib increases toxicity of dolasetron by QTc interval. Use Caution/Monitor.
- sertraline
dolasetron and sertraline both increase QTc interval. Use Caution/Monitor.
- solifenacin
dolasetron and solifenacin both increase QTc interval. Use Caution/Monitor.
- sorafenib
sorafenib and dolasetron both increase QTc interval. Use Caution/Monitor.
- sulfamethoxazole
sulfamethoxazole and dolasetron both increase QTc interval. Use Caution/Monitor.
- sunitinib
dolasetron and sunitinib both increase QTc interval. Use Caution/Monitor.
- tacrolimus
dolasetron and tacrolimus both increase QTc interval. Use Caution/Monitor.
- telavancin
dolasetron and telavancin both increase QTc interval. Use Caution/Monitor.
- thioridazine
thioridazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- trazodone
trazodone and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- triclabendazole
dolasetron and triclabendazole both increase QTc interval. Use Caution/Monitor.
- trifluoperazine
trifluoperazine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- trimethoprim
dolasetron and trimethoprim both increase QTc interval. Use Caution/Monitor.
- trimipramine
trimipramine and dolasetron both increase QTc interval. Modify Therapy/Monitor Closely.
- triptorelin
triptorelin increases toxicity of dolasetron by QTc interval. Use Caution/Monitor. Increases risk of torsades de pointes.
- tropisetron
dolasetron and tropisetron both increase QTc interval. Use Caution/Monitor.
- valbenazine
valbenazine and dolasetron both increase QTc interval. Use Caution/Monitor.
- vardenafil
dolasetron and vardenafil both increase QTc interval. Use Caution/Monitor.
- venlafaxine
dolasetron and venlafaxine both increase QTc interval. Use Caution/Monitor.
- voclosporin
voclosporin, dolasetron. Either increases effects of the other by QTc interval. Use Caution/Monitor.
- voriconazole
dolasetron and voriconazole both increase QTc interval. Use Caution/Monitor.
- vorinostat
dolasetron and vorinostat both increase QTc interval. Use Caution/Monitor.
- ziprasidone
dolasetron and ziprasidone both increase QTc interval. Modify Therapy/Monitor Closely.
Minor (2)
- azithromycin
azithromycin and dolasetron both increase QTc interval. Minor/Significance Unknown.
- pazopanib
dolasetron and pazopanib both increase QTc interval. Minor/Significance Unknown.
Adverse Effects
>10%
Headache
Diarrhea
1-10%
Dizziness
Drowsiness
Fatigue
Bradycardia
HTN
Hypotension
Tachycardia
Abdominal pain
Dyspepsia
Abnormal liver function
Chills
Fever
Oliguria
Urinary retention
Pain
Pruritus
Warnings
Contraindications
Hypersensitivity
Coadministration with apomorphine; combination reported to cause profound hypotension and loss of consciousness
IV administration for chemotherapy-induced nausea/vomiting (CINV) because of risk for QT, PR, and QRS prolongation
Cautions
Patients at risk for prolongation of cardiac conduction intervals, particularly long QTc interval, congenital long QT syndrome, uncorrected hypokalemia or hypomagnesemia, or receiving other QT-prolonging drugs
Serotonin syndrome reported with 5-HT3 receptor antagonists alone but particularly with concomitant use of serotonergic drugs including SSRIs, SNRIs, MAO inhibitors, lithium, tramadol, methylene blue IV, and mirtazapine
Correct hypokalemia and hypomagnesemia before administration
Use electrocardiogram (ECG) monitoring in patients with congestive heart failure, bradycardia, underlying heart disease, renal impairment, or who are elderly
Pregnancy & Lactation
Pregnancy Category: B
Lactation: not known whether distributed into breast milk, use caution
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Mechanism of Action
Selective 5-HT3 receptor antagonist; dolasetron binds to 5-HT3 receptors located on vagal neurons in GI tract, blocking signal to vomiting center in the brain, thus preventing N/V
Pharmacokinetics
Half-life: parent compound <10 min, hydrodolasetron (active) 4-9 hr
Peak plasma time: IV: 0.6 hr, PO: 1-1.5 hr
Bioavailability: 59-80% (PO)
Vd: 5.8-10 L/kg
Protein binding: 69-77%
Metabolism: dolasetron is metabolized to hydrodolasetron (active) by carbonyl reductase; hydrodolasetron is subsequently metabolized by CYP2D6 and CYP3A
Metabolites: hydrodolasetron (active)
Total body clearance: 9.4-13.4 mL/min/kg
Renal clearance: 2.6-3.4 mg/kg
Excretion: urine (53-61%); feces (25-33%)
Administration
IV Preparation
For infusion, dilute to 50 mL in NS/D5W/D5 in 0.5 NS/D5 in LR/LR/10% mannitol injection
Store vial at room temp
Dilution stable for 24 hr at room temp or 48 hr refrigerated
IV Administration
IVP 100 mg/30 sec OR
Dilute as above and infuse over up to 15 min
After dilution, use within 24 hr, or 48 hr if refrigerated
Do not mix with other drugs
Flush infusion line before and after administration
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Anzemet oral - | 50 mg tablet |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
dolasetron oral
DOLASETRON - ORAL
(doe-LAS-e-tron)
COMMON BRAND NAME(S): Anzemet
USES: This medication is used to prevent nausea and vomiting caused by cancer drug treatment (chemotherapy). Dolasetron works by blocking one of the body's natural substances (serotonin) that causes vomiting.
HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually within 1 hour before the start of chemotherapy.For children, the dosage is based on age and weight. Take this medication exactly as prescribed to get the most benefit from it. Do not increase your dose or use this drug more often or for longer than prescribed.Tell your doctor if you vomit or feel nauseated.
SIDE EFFECTS: Headache, diarrhea, tiredness, or dizziness may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Get medical help right away if you have any very serious side effects, including: severe dizziness, fainting, slow/fast/irregular heartbeat.This medication may increase serotonin and rarely cause a very serious condition called serotonin syndrome/toxicity. The risk increases if you are also taking other drugs that increase serotonin, so tell your doctor or pharmacist of all the drugs you take (see Drug Interactions section). Get medical help right away if you develop some of the following symptoms: fast heartbeat, hallucinations, loss of coordination, severe dizziness, severe nausea/vomiting/diarrhea, twitching muscles, unexplained fever, unusual agitation/restlessness.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking dolasetron, tell your doctor or pharmacist if you are allergic to it; or to other anti-nausea serotonin blockers (such as granisetron, ondansetron); or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: kidney disease.Dolasetron may cause a condition that affects the heart rhythm (QT prolongation). QT prolongation can rarely cause serious (rarely fatal) fast/irregular heartbeat and other symptoms (such as severe dizziness, fainting) that need medical attention right away.The risk of QT prolongation may be increased if you have certain medical conditions or are taking other drugs that may cause QT prolongation. Before using dolasetron, tell your doctor or pharmacist of all the drugs you take and if you have any of the following conditions: certain heart problems (heart failure, slow heartbeat, QT prolongation in the EKG), family history of certain heart problems (QT prolongation in the EKG, sudden cardiac death).Low levels of potassium or magnesium in the blood may also increase your risk of QT prolongation. This risk may increase if you use certain drugs (such as diuretics/"water pills") or if you have conditions such as severe sweating, diarrhea, or vomiting. Talk to your doctor about using dolasetron safely.This drug may make you dizzy. Alcohol or marijuana (cannabis) can make you more dizzy. Do not drive, use machinery, or do anything that needs alertness until you can do it safely. Limit alcoholic beverages. Talk to your doctor if you are using marijuana (cannabis).Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).Older adults may be more sensitive to the side effects of this drug, especially irregular heartbeat and QT prolongation (see above).During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.It is unknown if this medication passes into breast milk. Consult your doctor before breast-feeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug are: apomorphine, ziprasidone.The risk of serotonin syndrome/toxicity increases if you are also taking other drugs that increase serotonin. Examples include street drugs such as MDMA/"ecstasy," St. John's wort, certain antidepressants (including SSRIs such as fluoxetine/paroxetine, SNRIs such as duloxetine/venlafaxine), among others. The risk of serotonin syndrome/toxicity may be more likely when you start or increase the dose of these drugs.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Do not share this medication with others.Lab and/or medical tests (such as EKG, blood mineral levels) may be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.
MISSED DOSE: It is important to take each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule. Do not double the dose to catch up.
STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.
Information last revised June 2022. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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