Aloxi (palonosetron hydrochloride)
Eisai; generics available · 5-HT3 Receptor Antagonist / Antiemetic
What is Aloxi? Aloxi (palonosetron HCl) is a second-generation 5-HT3 receptor antagonist with a longer half-life than older agents. It is used to prevent acute and delayed chemotherapy-induced nausea and vomiting (CINV) and postoperative nausea and vomiting (PONV).
About Aloxi
| Brand Name | Aloxi |
| Generic / INN | palonosetron hydrochloride |
| Drug Class | 5-HT3 Receptor Antagonist / Antiemetic |
| Manufacturer | Eisai; generics available |
| Administration | Intravenous (IV) injection |
| FDA Approval | 2003 |
FDA-Approved Uses for Aloxi
Indications are based on FDA approval. Your healthcare provider determines appropriate use based on your specific diagnosis, stage, biomarker status, and overall clinical picture.
- Prevention of acute nausea and vomiting associated with initial and repeat courses of moderately and highly emetogenic chemotherapy
- Prevention of delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy
- Prevention of postoperative nausea and vomiting (PONV) for up to 24 hours
How Does Aloxi Work?
Palonosetron selectively antagonizes the 5-HT3 serotonin receptor with a higher binding affinity and longer half-life (~40 hours) than first-generation 5-HT3 antagonists (ondansetron, granisetron). It also has allosteric binding properties and may inhibit substance P-mediated pathways, contributing to its efficacy in delayed CINV.
Dosage & Administration
CINV: 0.25 mg IV over 30 seconds, administered 30 minutes before chemotherapy. Single dose per chemotherapy cycle. PONV: 0.075 mg IV immediately before anesthesia induction.
Warnings, Precautions & Side Effects
General Warning
QT prolongation possible (less than with dolasetron/older agents). Serotonin syndrome risk with concomitant serotonergic agents. Hypersensitivity reactions. Use with caution in patients with congenital long QT syndrome.
Common Side Effects
- Headache
- Constipation
- Diarrhea
- Dizziness
- Fatigue
- Abdominal pain
This is not a complete list. Always report new or worsening symptoms to your healthcare provider promptly.
Storage & Handling
Store at room temperature 20°C to 25°C (68°F to 77°F). Protect from freezing and light.
BiologicHealthPlus provides temperature-monitored cold-chain specialty delivery for medications requiring refrigeration. Never use a medication if its storage conditions have been compromised.
Insurance Coverage, Prior Authorization & Patient Assistance
🛡️ Commercial Insurance
Aloxi is covered by most major commercial insurance plans when medically necessary and prior authorized. Coverage tier and cost-sharing vary by plan.
✅ Prior Authorization
Prior authorization is required by virtually all insurance plans for Aloxi. BiologicHealthPlus handles the complete prior authorization process at no cost to patients or providers.
🏥 Medicare Coverage
Medicare Part B covers this IV medication when administered in a clinical setting. Medicaid coverage varies by state.
🆓 Patient Assistance
Manufacturer patient assistance programs may be available for eligible uninsured or underinsured patients. Contact BiologicHealthPlus for a confidential eligibility review.
Prior Authorization Patient Assistance Insurance & Savings Medication Costs
Frequently Asked Questions — Aloxi
Aloxi (palonosetron) is a 5-HT3 antagonist antiemetic with a longer half-life (~40 hours) than older agents like ondansetron. It is given as a single IV injection before chemotherapy to prevent both acute and delayed nausea and vomiting.
Palonosetron has higher binding affinity for the 5-HT3 receptor, a much longer half-life (~40 vs ~4 hours), and may have efficacy in delayed CINV that ondansetron lacks. It is typically given as a single dose per cycle rather than repeatedly.
Yes. Generic palonosetron 0.25 mg/5 mL injection is available from multiple manufacturers.
Related Medications & Conditions
Related Medications
Akynzeo (netupitant/palonosetron) · Ondansetron (Zofran) · Granisetron · Aprepitant (Emend) · Dexamethasone
Related Conditions
Chemotherapy-induced nausea and vomiting (CINV) · Postoperative nausea and vomiting (PONV)