Netupitant and palonosetron oral
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Oral formulations of netupitant and palonosetron hydrochloride.
Drugs List
Therapeutic Indications
Uses
Prevention of CINV with highly emetogenic cisplatin based chemotherapy
Prevention of CINV with moderately emetogenic chemotherapy
Dosage
Adults
One capsule administered approximately one hour prior to the start of each chemotherapy cycle.
Contraindications
Children under 18 years
Breastfeeding
End stage renal disease
Hereditary fructose intolerance
Long QT syndrome
Pregnancy
Torsade de pointes
Precautions and Warnings
Constipation
Family history of long QT syndrome
Females of childbearing potential
Patients over 75 years
Suspected gastrointestinal obstruction
Electrolyte imbalance
Glucose-galactose malabsorption syndrome
History of torsade de pointes
Severe hepatic impairment
Correct electrolyte disorders before treatment
Advise ability to drive/operate machinery may be affected by side effects
Contains soya or soya derivative
Preparation contains sucrose
Presentations with sorbitol unsuitable in hereditary fructose intolerance
Exclude pregnancy prior to initiation of treatment
Consider monitoring ECG in patients at risk of QT prolongation
Monitor patients for signs and symptoms of Serotonin Syndrome
Monitor patients with signs of sub-acute intestinal obstruction
Monitor serum electrolytes
May induce or worsen existing constipation
Advise patient not to take St John's wort concurrently
Female: Contraception required during and for 1 month after treatment
Breastfeeding: Do not breastfeed during & for 1 month after treatment
Pregnancy and Lactation
Pregnancy
Netupitant and palonosetron is contraindicated during pregnancy.
Use of netupitant and palonosetron during pregnancy is contraindicated by the manufacturer.
There is no data regarding the use of netupitant in pregnant women. Animal studies have shown reproductive toxicity including teratogenic effects in rabbit without safety margin.
There is no data regarding the use of palonosetron in pregnant women. Animal studies do not indicate direct or indirect harmful effects of palonosetron with the respect to reproductive toxicity.
Lactation
Netupitant and palonosetron is contraindicated during breastfeeding.
It is unknown whether palonosetron or netupitant are excreted in human milk. A risk to the suckling child cannot be excluded. The manufacturer recommends breastfeeding should be discontinued during treatment with netupitant and palonosetron and for 1 month after the last dose.
Side Effects
Abdominal pain
Alopecia
Arrhythmias
Asthenia
Atrioventricular block
Back pain
Blurred vision
Bundle branch block
Cardiomyopathy
Coated tongue
Conduction disturbances
Conjunctivitis
Constipation
Creatine phosphokinase increased
Cystitis
Decreased appetite
Diarrhoea
Dizziness
Dyspepsia
Dysphagia
ECG changes
Fatigue
Feeling hot
Flatulence
Headache
Hiccups
Hypertension
Hypoaesthesia
Hypokalaemia
Hypotension
Increase in alkaline phosphatase
Increase of liver transaminases
Insomnia
Leucocytosis
Leukopenia
Lymphocytosis
Mitral insufficiency
Mood changes
Myocardial ischaemia
Nausea
Neutropenia
Non-cardiac chest pain
Product taste abnormal
Prolongation of QT interval
Psychosis
Serum bilirubin increased
Serum creatinine increased
Sleep disturbances
Troponin increased
Urticaria
Ventricular extrasystoles
Vertigo
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: November 2019
Reference Sources
Summary of Product Characteristics: Akynzeo 300mg 0.5mg hard capsules. Chugai Pharma Ltd. Revised September 2017.
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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