Drug General Information (ID: DDI4YB5DUT)
  Drug Name Dolasetron Drug Info Lithium carbonate Drug Info
  Drug Type Small molecule Small molecule
  Therapeutic Class Antiemetics Antimanic Agents
  Structure

 Mechanism of Dolasetron-Lithium carbonate Interaction (Severity Level: Major)
     Additive serotonergic effects Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Dolasetron Lithium carbonate
      Mechanism 1 Serotonergic effects
5-HT 3 receptor  Antagonist
Serotonergic effects
      Key Mechanism Factor 1
Factor Name 5-HT 3 receptor Structure Sequence
Protein Family Ligand-gated ion channel (TC 1.A.9) family
Protein Function
This is one of the several different receptors for 5-hydroxytryptamine (serotonin), a biogenic hormone that functions as a neurotransmitter, a hormone, and a mitogen. This receptor is a ligand-gated ion channel, which when activated causes fast, depolarizing responses in neurons. It is a cation-specific, but otherwise relatively nonselective, ion channel.
    Click to Show/Hide
      Mechanism Description
  • Additive serotonergic effects by the combination of Dolasetron and Lithium carbonate 
     Increased risk of prolong QT interval Click to Show/Hide Mechanism Graph
Could Not Find 2D Structure
      Drug Name Dolasetron Lithium carbonate
      Mechanism 2 Prolong QT interval Prolong QT interval
      Key Mechanism Factor 2
Factor Name QT interval
Factor Description Long QT syndrome is a heart signaling disorder that can cause a fast, chaotic heartbeat (arrhythmia). Many people may not exhibit symptoms, and usually the condition is detected during routine medical tests. In others, the most common symptoms include: sudden fainting, palpitations, dizziness, seizures, sudden death.
      Mechanism Description
  • Increased risk of prolong QT interval by the combination of Dolasetron and Lithium carbonate 

Recommended Action
      Management Caution is advised if 5-HT3 receptor antagonists are prescribed with other agents that affect the serotonergic neurotransmitter system. Patients should be closely monitored for symptoms of the serotonin syndrome during treatment. Particular caution is warranted when initiating or increasing the dosages of these agents. In addition, the potential risk for serotonin syndrome should be considered even when administering serotonergic agents sequentially, as some agents may demonstrate a prolonged elimination half-life. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should be discontinued immediately and supportive care rendered as necessary. Moderately ill patients may also benefit from the administration of a serotonin antagonist (e.g., cyproheptadine, chlorpromazine). Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures. Due to the potential for additive effects on the QT interval, ECG monitoring may also be appropriate when 5-HT3 receptor antagonists are used with certain antidepressants or lithium. Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.

References
1 Cerner Multum, Inc. "Australian Product Information.".
2 Product Information. Anzemet (dolasetron). Hoechst Marion-Roussel Inc, Kansas City, MO.
3 Product Information. Sancuso (granisetron). ProStrakan Group, Bedminster, NJ.