Netupitant Fosnetupitant Palonosetron Brand Name– Akynzeo
What is Netupitant Fosnetupitant Palonosetron
Netupitant Fosnetupitant Palonosetron are combination products containing 2 antiemetic agents.
Netupitant is a selective substance P neurokinin 1 (NK1) receptor antagonist that prevents nausea and vomiting during both the acute and delayed phase after chemotherapy; fosnetupitant is a prodrug of netupitant.
Palonosetron is a highly selective 5-HT3 receptor antagonist that prevents nausea and vomiting during the acute phase. Akynzeo capsules contain netupitant; palonosetron.
Akynzeo solution for injection and Akynzeo injection contain fosnetupitant; palonosetron.
The combination products are used with dexamethasone for the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) associated with initial and repeat courses of chemotherapy, including, but not limited to, highly emetogenic chemotherapy.
The capsules and injection have been studied in patients receiving platinum-based chemotherapy; however, only the oral formulation has been studied in patients receiving anthracycline and cyclophosphamide based chemotherapy.
Indications
- chemotherapy-induced nausea/vomiting prophylaxis
For acute and delayed chemotherapy-induced nausea/vomiting prophylaxis (CINV prophylaxis) associated with initial and repeat courses of cancer chemotherapy, including, but not limited to, highly emetogenic chemotherapy
for patients receiving highly emetogenic chemotherapy, including cisplatin-based chemotherapy
Side Effects
- abdominal pain
- amblyopia
- anaphylactic shock
- anaphylactoid reactions
- anorexia
- anxiety
- arthralgia
- asthenia
- bradycardia
- chills
- constipation
- diarrhea
- dizziness
- drowsiness
- dyskinesia
- dyspepsia
- edema
- elevated hepatic enzymes
- erythema
- euphoria
- fatigue
- fever
- flatulence
- glycosuria
- headache
- hiccups
- hot flashes
- hyperbilirubinemia
- hyperglycemia
- hyperkalemia
- hypersalivation
- hypertension
- hypokalemia
- hypotension
- hypoventilation
- insomnia
- laryngospasm
- metabolic acidosis
- ocular irritation
- paresthesias
- pruritus
- QT prolongation
- rash
- serotonin syndrome
- sinus tachycardia
- thrombocytopenia
- tinnitus
- urinary retention
- weakness
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- breast-feeding
- children
- dolasetron hypersensitivity
- granisetron hypersensitivity
- hepatic disease
- infants
- neonates
- ondansetron hypersensitivity
- palonosetron hypersensitivity
- pregnancy
- renal failure
- renal impairment
Interactions
- Abemaciclib
- Acalabrutinib
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Codeine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Tramadol
- Alfentanil
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Alosetron
- Alprazolam
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amprenavir
- Apixaban
- Aprepitant, Fosaprepitant
- Artemether; Lumefantrine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Avapritinib
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Boceprevir
- Bortezomib
- Bosutinib
- Brigatinib
- Bromocriptine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Cannabidiol
- Carbamazepine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Ceritinib
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Citalopram
- Clarithromycin
- Clomipramine
- Cobicistat
- Cobimetinib
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- Colchicine
- Colchicine; Probenecid
- Conivaptan
- Crizotinib
- Cyclophosphamide
- Dabrafenib
- Daclatasvir
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Deflazacort
- Delavirdine
- Desvenlafaxine
- Dexamethasone
- Dextromethorphan; Quinidine
- Dichlorphenamide
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Disulfiram
- Docetaxel
- Donepezil
- Donepezil; Memantine
- Dronabinol
- Dronedarone
- Duloxetine
- Duvelisib
- Elbasvir; Grazoprevir
- Eletriptan
- Elexacaftor; tezacaftor; ivacaftor
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Encorafenib
- Entrectinib
- Enzalutamide
- Eplerenone
- Escitalopram
- Eszopiclone
- Ethinyl Estradiol; Etonogestrel
- Ethosuximide
- Etonogestrel
- Ezetimibe; Simvastatin
- Fentanyl
- Flibanserin
- Fluconazole
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluticasone; Umeclidinium; Vilanterol
- Fluticasone; Vilanterol
- Fluvoxamine
- Fosamprenavir
- Fosphenytoin
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanfacine
- Homatropine; Hydrocodone
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydroxyprogesterone
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibrutinib
- Ibuprofen; Oxycodone
- Idelalisib
- Ifosfamide
- Imatinib
- Indinavir
- Isavuconazonium
- Isocarboxazid
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Itraconazole
- Ivabradine
- Ivacaftor
- Ivosidenib
- Ketoconazole
- Lefamulin
- Lemborexant
- Lesinurad
- Lesinurad; Allopurinol
- Letermovir
- Levomilnacipran
- Lidocaine
- Lidocaine; Prilocaine
- Linezolid
- Lithium
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
- Lurasidone
- Lurbinectedin
- Maraviroc
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methylene Blue
- Midazolam
- Milnacipran
- Mirabegron
- Mirtazapine
- Mitotane
- Monoamine oxidase inhibitors
- Naldemedine
- Naloxegol
- Nanoparticle Albumin-Bound Paclitaxel
- Nefazodone
- Nelfinavir
- Neratinib
- Niacin; Simvastatin
- Nisoldipine
- Olaparib
- Ombitasvir; Paritaprevir; Ritonavir
- Oxycodone
- Ozanimod
- Paclitaxel
- Paroxetine
- Peginterferon Alfa-2b
- Pemigatinib
- Perindopril; Amlodipine
- Pexidartinib
- Phenelzine
- Phenobarbital
- Phenytoin
- Pimozide
- Posaconazole
- Primidone
- Quazepam
- Quinidine
- Ranolazine
- Ribociclib
- Ribociclib; Letrozole
- Rifampin
- Rimegepant
- Ritonavir
- Ruxolitinib
- Saquinavir
- Segesterone Acetate; Ethinyl Estradiol
- Selpercatinib
- Selumetinib
- Sertraline
- Sildenafil
- Simvastatin
- Simvastatin; Sitagliptin
- Siponimod
- Sofosbuvir; Velpatasvir
- Sofosbuvir; Velpatasvir; Voxilaprevir
- Sonidegib
- St. John’s Wort, Hypericum perforatum
- Sufentanil
- Suvorexant
- Tadalafil
- Tazemetostat
- Telaprevir
- Telithromycin
- Telotristat Ethyl
- Tezacaftor; Ivacaftor
- Tiagabine
- Ticagrelor
- Tipranavir
- Tolvaptan
- Tramadol
- Tranylcypromine
- Trazodone
- Triazolam
- Tucatinib
- Ubrogepant
- Umeclidinium; Vilanterol
- Vardenafil
- Venetoclax
- Venlafaxine
- Vilazodone
- Vinblastine
- Vincristine
- Vincristine Liposomal
- Vinorelbine
- Voriconazole
- Warfarin
- Zanubrutinib
- Zolpidem
