When This Medicine Should Not Be Used:
This medicine is not right for everyone. You should not receive it if you had an allergic reaction to palonosetron.

How to Use This Medicine:
Injectable

• Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine.
• This medicine is usually given about 30 minutes before the start of chemotherapy or right before you receive anesthetic medicine for surgery.
• Read and follow the patient instructions that come with this medicine. Talk to your doctor or pharmacist if you have any questions.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how palonosetron works. Tell your doctor if you are using any of the following:
  
  • Fentanyl, lithium, tramadol, mirtazapine
  • Medicine to treat depression
  • MAO inhibitor (MAOI)

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you had an allergic reaction to another medicine for nausea or vomiting.
• This medicine may cause a serious drug reaction called serotonin syndrome (more likely if used together with certain other medicines).

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Anxiety, restlessness, fever, sweating, muscle spasms, nausea, vomiting, diarrhea, seeing or hearing things that are not there
• Chest pain, fast, slow, pounding, or uneven heartbeat
• Lightheadedness, dizziness, fainting

If you notice these less serious side effects, talk with your doctor:

• Pain, redness, swelling, or a lump under your skin where the needle is placed

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088