Netupitant and palonosetron is a combination medicine used to help prevent nausea and vomiting caused by chemotherapy. netupitant and palonosetron is given together with a steroid called dexamethasone.

Netupitant and palonosetron helps prevent nausea and vomiting that occurs both during chemotherapy and later on (delayed nausea and vomiting).

Netupitant and palonosetron may also be used for purposes not listed in this medication guide.

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

This medicine is given ahead of time and will not treat nausea or vomiting you already have.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

About 1 hour before chemotherapy, you will take netupitant and palonosetron with or without food.

You will take dexamethasone 30 minutes before chemotherapy, and you may need to keep taking it for 3 days afterward. Follow your doctor's dosing instructions very carefully.

Store the capsules at room temperature away from moisture and heat.

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

Netupitant and palonosetron is not approved for use by anyone younger than 18 years old.

Tell your doctor if you have ever had:

• liver or kidney disease; or

• an allergic reaction to a medicine for nausea or vomiting, such as dolasetron (Anzemet), ondansetron (Zofran), or palonosetron (Aloxi).

Be sure your doctor knows if you also take stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, or serious infections. These medicines may interact with netupitant and palonosetron and cause a serious condition called serotonin syndrome.

Netupitant and palonosetron may harm an unborn baby. Tell your doctor if you become pregnant.

You should not breast-feed while using netupitant and palonosetron.

Call your doctor for instructions if you have not taken netupitant and palonosetron at the correct time before your chemotherapy.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from light, excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unless your doctor tells you otherwise, continue your normal diet.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Get emergency medical help if you have signs of an allergic reaction: hives; chest pain, difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects of netupitant and palonosetron may include:

• headache;

• feeling weak or tired;

• skin redness; or

• upset stomach, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.

Many drugs can affect netupitant and palonosetron. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using.

Keep all appointments with your doctor.

Do not let anyone else take your medication.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.