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.
Dosing is individualized by the prescribing clinician. Never adjust your dose without consulting your healthcare provider. This information is educational only and does not replace the official prescribing information.
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.
- QT prolongation
- Serotonin syndrome (with concomitant serotonergic agents)
- Hypersensitivity reactions
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)