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This document provides essential safety information regarding the use of Anzemet (dolasetron). It is advised that you carefully review the following points and discuss any concerns with your healthcare provider.

• Heart Rhythm Risks: Anzemet may cause changes in your heart rhythm, potentially leading to serious conditions such as QT prolongation. This risk is heightened if you have low potassium or magnesium levels, are of older age, have kidney issues, or a history of heart problems, including slow heart rate or arrhythmias. Additionally, your risk increases if you or your family have a history of long QT syndrome or if you are taking other medications that affect heart rhythm, such as amiodarone or ciprofloxacin.

• Serotonin Syndrome: There is a risk of developing serotonin syndrome, a rare but potentially life-threatening condition, when taking Anzemet. This risk increases if you are also using other medications that elevate serotonin levels in the brain, such as certain antidepressants, medications for mental health, pain medications, and migraine drugs.

• Severe Allergic Reactions: Some individuals may experience severe allergic reactions to Anzemet, which can be life-threatening. Symptoms may include facial swelling, hives, anaphylaxis (e.g., throat closure), dizziness, fast heartbeat, difficulty breathing, and swelling around the eyes, lips, or tongue. If you experience these symptoms, seek medical attention immediately.

Please note that there are no specified contraindications for Anzemet at this time. Always consult with your healthcare provider before starting this medication to ensure it is safe for you.

When taking this medication, some common side effects may be experienced, such as headaches, which occur in 18-23% of users, along with fatigue, dizziness, diarrhea, and indigestion. These side effects are typically mild, but if they persist or worsen, it's advisable to consult your healthcare provider for guidance.

In addition to these, some individuals might experience changes in heart rate, either faster or slower, chills, or general pain. While these effects are generally manageable, monitoring their progression is important.

More rarely, the medication can cause serious side effects that necessitate immediate medical attention. These include severe dizziness, fainting, or an irregular heartbeat, which can manifest as chest pounding, shortness of breath, or chest pain. Additionally, a serious condition known as serotonin syndrome can occur, characterized by symptoms such as a rapid heartbeat, severe nausea, vomiting, diarrhea, muscle twitching, unexplained fever, hallucinations, or a loss of coordination. Immediate medical help is also crucial if you experience signs of a severe allergic reaction, such as a rash, itching, swelling, particularly of the face, tongue, or throat, or difficulty breathing.

While these severe side effects are rare, being aware of them is vital for your safety. Always communicate with your healthcare provider about any side effects you experience, especially if they are unusual or cause concern.

When taking Anzemet (dolasetron), be cautious of potential interactions with certain medications or supplements. You must inform your doctor or pharmacist about all the medications, including street drugs, vitamins, and herbal supplements, you are currently using.

Anzemet should not be used with apomorphine and Ziprasidone, as these combinations can be harmful. Additionally, there is an increased risk of serotonin syndrome, a potentially serious condition, if Anzemet is used with drugs that elevate serotonin levels. These include street drugs like MDMA or "ecstasy," certain antidepressants such as SSRIs like Fluoxetine and paroxetine, and SNRIs like Duloxetine and Venlafaxine. The risk is higher when starting or increasing the dose of these medications.

Some drugs, while usually not recommended with Anzemet, may be necessary in certain situations. In these instances, your doctor might adjust the dosage or frequency. A few examples are: bepridil, cisapride, dronedarone, levomethadyl, mesoridazine, Pimozide, piperaquine, saquinavir, sparfloxacin, terfenadine, and Thioridazine. Always consult with your healthcare provider to safely manage these combinations.