Aloxi 250 micrograms/5 mL solution for injection – palonosetron for preventing chemotherapy-induced nausea and vomiting

Aloxi is a medicine containing palonosetron, a serotonin (5HT3) receptor antagonist. It blocks the action of serotonin, a substance that can cause nausea and vomiting. In Serbia it is authorised as a 250 micrograms/5 mL solution for injection in a glass vial.

According to the official leaflet, Aloxi is used to prevent nausea and vomiting caused by chemotherapy in adults, adolescents and children older than one month. It is used only in inpatient healthcare facilities – it is given by a doctor or nurse.

What is Aloxi (palonosetron) used for and how is it given?

Key facts about the medicine

What is Aloxi used for?

According to the official leaflet, Aloxi is used to prevent nausea and vomiting caused by chemotherapy in adult patients, adolescents and children older than one month.

How is it used and dosed?

• The medicine is given by a doctor or nurse 30 minutes before chemotherapy starts.
• Adults: the usual dose is 250 micrograms as a rapid intravenous injection.
• Children and adolescents (1 month to 17 years): the doctor calculates the dose by body weight, up to 1500 micrograms, as a slow intravenous infusion.
• Use in the days after chemotherapy is not recommended unless another cycle follows.

Special patient groups

• Children older than one month and adolescents: the dose is based on body weight.
• Patients with heart disease, heart rhythm or electrolyte disorders: special caution and medical assessment are needed.

Contraindications – when the medicine must not be used

Aloxi must not be given if you are allergic to palonosetron or any of the excipients.

Precautions and warnings

• acute bowel obstruction or a history of frequent constipation;
• heart disease such as heart rhythm changes (QT prolongation), in you or your family;
• an untreated imbalance of blood minerals (e.g. potassium and magnesium).

Interactions with other medicines, food and drink

Tell your doctor about all medicines you take, especially:

• SSRI antidepressants (fluoxetine, paroxetine, sertraline, fluvoxamine, citalopram, escitalopram) and SNRIs (venlafaxine, duloxetine) – possible serotonin syndrome;
• medicines that affect heart rhythm: amiodarone, nicardipine, quinidine, moxifloxacin, erythromycin, haloperidol, chlorpromazine, quetiapine, thioridazine and domperidone.

Pregnancy and breastfeeding

In pregnancy the doctor will not give Aloxi unless it is considered necessary; it is not known whether it can cause harmful effects. It is not known whether it passes into breast milk – breastfeeding women should consult their doctor before use.

Driving and using machines

Aloxi may cause dizziness or tiredness. If these occur, do not drive or use machines.

Possible side effects

• Adults – common (up to 1 in 10): headache, dizziness, constipation, diarrhoea.
• Adults – uncommon (up to 1 in 100): high or low blood pressure, heart disorders, vein changes, potassium imbalance, raised blood sugar, low calcium, raised bilirubin and liver enzymes, agitation, drowsiness or insomnia, loss of appetite, weakness, tiredness, tingling of the skin, itchy rash, visual disturbance, ringing in the ears, hiccups, bloating, dry mouth, stomach pain, difficulty passing urine, joint pain, QT prolongation.
• Very rare: burning or pain at the injection site; allergic reaction (swelling of the lips, face, tongue or throat, difficulty breathing, collapse, hives).
• Children – common headache; uncommon dizziness, body jerks, heart disorders, cough or shortness of breath, nosebleed, rash, fever, pain at the infusion site.

Report any suspected side effect to your doctor, pharmacist, nurse or ALIMS.

Overdose, missed dose and stopping treatment

The medicine is given by healthcare staff, so dosing errors are unlikely. According to the Summary of Product Characteristics no cases of overdose have been reported; in adult clinical studies doses up to 6 mg were used without dose-related adverse reactions. In case of overdose, general measures and symptomatic treatment are used. Use in further cycles is decided by the doctor.

Related information

• Products for nausea and vomiting

Composition, packaging and manufacturer

• Active substance: palonosetron (as palonosetron hydrochloride), 50 micrograms per 1 mL; 250 micrograms per 5 mL vial.
• Excipients: mannitol, disodium edetate, sodium citrate, citric acid monohydrate, sodium hydroxide, hydrochloric acid, water for injections. Contains less than 1 mmol (23 mg) sodium per vial.
• Appearance: clear, colourless solution in a colourless glass vial with rubber stopper and flip-off cap.
• Marketing authorisation holder: PHARMASWISS D.O.O., BEOGRAD, Batajnički drum 5 A, Belgrade.
• Manufacturer: HELSINN BIREX PHARMACEUTICALS LTD., Damastown, Mulhuddart, Dublin, Ireland.

Storage

• This medicine does not require any special storage conditions.
• Once opened, use immediately.
• Do not use after the expiry date; keep out of the sight and reach of children.

Frequently asked questions

When is Aloxi given?

Once, 30 minutes before chemotherapy starts, as an intravenous injection (in children as a slow infusion).

Can Aloxi be bought in a pharmacy?

No. The medicine may be used only in inpatient healthcare facilities.

Can Aloxi be given with antidepressants?

With SSRI and SNRI antidepressants serotonin syndrome is possible, so the doctor must know about them and use them with caution.

What are the most common side effects?

In adults headache, dizziness, constipation and diarrhoea; in children mostly headache.

Sources

• ALIMS – Package leaflet Aloxi®, 250 micrograms/5 mL, solution for injection (January 2023, in Serbian)
• ALIMS – Summary of Product Characteristics Aloxi® (in Serbian)

Date sources were checked: 24.10.2026.