Drug Detail:Akynzeo (Netupitant and palonosetron (oral) [ net-ue-pi-tant-and-pal-oh-noe-se-tron ])
Drug Class: Miscellaneous antiemetics
Usual Adult Dose for Nausea/Vomiting - Chemotherapy Induced
Netupitant 300 mg-palonosetron 0.5 mg orally ONCE, given 60 minutes before chemotherapy on Day 1
ADDITIONAL MEDICATIONS:
Highly Emetogenic Cancer Chemotherapy, Including Cisplatin-Based Chemotherapy:
- Day 1: Dexamethasone 12 mg orally 30 minutes prior to chemotherapy
- Days 2 to 4: Dexamethasone 8 mg orally once a day
Anthracyclines and Cyclophosphamide-Based Chemotherapy and Chemotherapy Not Considered Highly Emetogenic:
- Day 1: Dexamethasone 12 mg orally 30 minutes prior to chemotherapy
Use: In combination with dexamethasone for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of cancer chemotherapy, including, but not limited to, highly emetogenic chemotherapy
Renal Dose Adjustments
Mild to moderate renal dysfunction (CrCl 30 to 60 mL/min): No adjustment recommended.
Severe renal dysfunction (CrCl less than 30 mL/min) and end-stage renal disease: Not recommended.
Liver Dose Adjustments
Mild to moderate liver dysfunction (Child-Pugh score 5 to 8): No adjustment recommended.
Severe liver dysfunction (Child-Pugh score greater than 9): Not recommended.
Precautions
CONTRAINDICATIONS: None
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Administration advice:
- This drug can be taken without regard to food.
Storage requirements:
- Some experts recommend: Store in the original container
General:
- LIMITATION OF USE: This drug has not been studied for the prevention of nausea/vomiting associated with anthracycline PLUS cyclophosphamide chemotherapy.
Monitoring:
- HYPERSENSITIVITY: Hypersensitivity reactions
- NERVOUS SYSTEM: Signs/symptoms of serotonin syndrome
Patient advice:
- Patients should be advised to immediately report any signs/symptoms associated with serotonin syndrome or hypersensitivity reactions to their prescribers.
- Advise patients to speak to their healthcare provider if they become pregnant, intend to become pregnant, or are breastfeeding.
- Inform patients that this drug may cause dizziness, fatigue, and/or somnolence, and they should avoid driving or operating machinery if these side effects occur.
