Netupitant and palonosetron (Oral route)

Pronunciation:

net-UE-pi-tant, pal-oh-NOE-se-tron

Brand Names:

Akynzeo

Dosage Forms:

Capsule

Classifications:

Therapeutic—

Antiemetic

Pharmacologic—

Neurokinin-1 Receptor Antagonist

Uses of This Medicine:

Netupitant and palonosetron combination is used to prevent nausea and vomiting that is caused by cancer medicines (chemotherapy). Palonosetron and netupitant work by blocking the signals to the brain that cause nausea and vomiting.

This medicine is available only with your doctor's prescription.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies have not been performed on the relationship of age to the effects of netupitant and palonosetron combination in the pediatric population. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of netupitant and palonosetron combination in the elderly. However, elderly patients are more likely to have kidney, liver, or heart problems, which may require caution in patients receiving netupitant and palonosetron combination.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Apomorphine
Eliglustat

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Abametapir
Acalabrutinib
Alfentanil
Alfuzosin
Almotriptan
Alprazolam
Amineptine
Amiodarone
Amitriptyline
Amitriptylinoxide
Amlodipine
Amoxapine
Amphetamine
Aprepitant
Aripiprazole
Atorvastatin
Avanafil
Avapritinib
Axitinib
Benzhydrocodone
Benzphetamine
Bosutinib
Brigatinib
Bromocriptine
Brompheniramine
Budesonide
Buprenorphine
Buspirone
Butorphanol
Cabozantinib
Capivasertib
Carbamazepine
Chlorpheniramine
Cilostazol
Cisapride
Citalopram
Clarithromycin
Clomipramine
Clozapine
Cobicistat
Cobimetinib
Cocaine
Codeine
Colchicine
Conivaptan
Copanlisib
Crizotinib
Cyclobenzaprine
Cyclosporine
Dabrafenib
Daclatasvir
Daridorexant
Darifenacin
Darunavir
Dasatinib
Desipramine
Desvenlafaxine
Dextroamphetamine
Dextromethorphan
Diazepam
Dibenzepin
Dihydrocodeine
Dihydroergotamine
Diltiazem
Docetaxel
Dofetilide
Domperidone
Doxepin
Dronedarone
Duloxetine
Efavirenz
Elacestrant
Elbasvir
Eletriptan
Elexacaftor
Encorafenib
Entrectinib
Enzalutamide
Eplerenone
Ergotamine
Erythromycin
Escitalopram
Estradiol
Eszopiclone
Everolimus
Fedratinib
Felodipine
Fenfluramine
Fentanyl
Fexinidazole
Finerenone
Flibanserin
Fluoxetine
Fluticasone
Fluvoxamine
Fosaprepitant
Fosphenytoin
Frovatriptan
Furazolidone
Gepirone
Granisetron
Grazoprevir
Guanfacine
Haloperidol
Hydrocodone
Hydrocortisone
Hydromorphone
Hydroxyamphetamine
Hydroxytryptophan
Ibrutinib
Imatinib
Imipramine
Indinavir
Infigratinib
Iproniazid
Irinotecan
Irinotecan Liposome
Isocarboxazid
Itraconazole
Ivabradine
Ivacaftor
Ivosidenib
Lapatinib
Larotrectinib
Lasmiditan
Lemborexant
Lercanidipine
Levomilnacipran
Levorphanol
Linezolid
Lisdexamfetamine
Lithium
Lofepramine
Lomitapide
Lorcaserin
Lovastatin
Lumacaftor
Lumateperone
Lurasidone
Lurbinectedin
Maraviroc
Mavacamten
Melitracen
Meperidine
Metaxalone
Methadone
Methamphetamine
Methylene Blue
Midazolam
Milnacipran
Mirtazapine
Mitapivat
Mitotane
Mobocertinib
Moclobemide
Morphine
Morphine Sulfate Liposome
Nalbuphine
Naloxegol
Naratriptan
Nateglinide
Nefazodone
Nelfinavir
Neratinib
Nialamide
Nifedipine
Nilotinib
Nirogacestat
Nisoldipine
Nortriptyline
Olaparib
Oliceridine
Omaveloxolone
Omeprazole
Ondansetron
Opipramol
Oxycodone
Oxymorphone
Paclitaxel
Pacritinib
Palovarotene
Paritaprevir
Paroxetine
Pemigatinib
Pentazocine
Pexidartinib
Phenelzine
Phenobarbital
Phenytoin
Pimavanserin
Pimozide
Piperaquine
Pralsetinib
Primidone
Procarbazine
Progesterone
Protriptyline
Quetiapine
Quinidine
Ranolazine
Rasagiline
Reboxetine
Remifentanil
Repaglinide
Repotrectinib
Rifabutin
Rifampin
Rimegepant
Rizatriptan
Roflumilast
Rolapitant
Salmeterol
Saquinavir
Saxagliptin
Selegiline
Selpercatinib
Selumetinib
Sertraline
Sibutramine
Sildenafil
Simeprevir
Simvastatin
Sirolimus
Sirolimus Protein-Bound
Sonidegib
Sparsentan
St John's Wort
Sufentanil
Sumatriptan
Sunitinib
Suvorexant
Tacrolimus
Tamoxifen
Tapentadol
Tazemetostat
Telithromycin
Temsirolimus
Tezacaftor
Thiotepa
Tianeptine
Ticagrelor
Tipranavir
Tolvaptan
Trabectedin
Tramadol
Tranylcypromine
Trazodone
Triazolam
Trimipramine
Tryptophan
Ubrogepant
Vardenafil
Venetoclax
Venlafaxine
Verapamil
Vilazodone
Vinblastine
Vincristine
Vinorelbine
Voclosporin
Vorapaxar
Vortioxetine
Warfarin
Zaleplon
Zanubrutinib
Ziprasidone
Zolmitriptan
Zolpidem

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Dexamethasone

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Proper Use of This Medicine:

Take this medicine only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

This medicine should come with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.

Take this medicine with or without food.

Dosing—

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

For oral dosage form (capsules):
- For prevention of nausea and vomiting caused by chemotherapy:
  - Adults—One capsule given within 1 hour before starting cancer treatment.
  - Children—Use and dose must be determined by your doctor.

Missed dose—

If you miss a dose of this medicine, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Precautions While Using This Medicine:

Check with your doctor if severe nausea and vomiting continue after leaving the hospital or cancer treatment center.

This medicine may cause serious allergic reactions, including anaphylaxis. Anaphylaxis can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, a fast heartbeat, fever, hives, itching, irritation, hoarseness, joint pain, stiffness or swelling, rash, redness of the skin, swelling of the eyelids, face, lips, hands, or feet, tightness in the chest, or trouble breathing or swallowing after using this medicine.

This medicine may cause a serious condition called serotonin syndrome if taken together with some medicines such as fentanyl (Abstral®, Duragesic®), lithium (Eskalith®, Lithobid®), a MAO inhibitor (such as methylene blue injection, Eldepryl®, Marplan®, Nardil®, Parnate®), medicine to treat migraine headaches (such as tramadol, Ultram®), or medicine to treat depression (eg, fluoxetine, mirtazapine, paroxetine, Celexa®, Effexor®, Lexapro®, Paxil®, Zoloft®). Check with your doctor first before taking any other medicines with netupitant and palonosetron combination.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

Incidence not known: Agitation; confusion; dizziness; fever; hearing or seeing things that are not there; muscle twitching; overactive reflexes; poor coordination; shivering; sweating; trembling or shaking

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common: Headache; fatigue; unusual tiredness or weakness

Less common: constipation; flushing or redness of the skin; heartburn; indigestion; stomach discomfort, upset, or pain

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

Last Updated: 4/24/2024

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