Netupitant and palonosetron (Oral)
Medically reviewed on June 7, 2018
Commonly used brand name(s)
In the U.S.
Available Dosage Forms:
Therapeutic Class: Antiemetic
Pharmacologic Class: Neurokinin-1 Receptor Antagonist
Uses For 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.
Netupitant and palonosetron 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 netupitant and palonosetron, the following should be considered:
Tell your doctor if you have ever had any unusual or allergic reaction to netupitant and palonosetron 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.
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.
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.
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.
Interactions with 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 netupitant and palonosetron, 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 netupitant and palonosetron 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.
Using netupitant and palonosetron 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.
- Irinotecan Liposome
- Methylene Blue
- Morphine Sulfate Liposome
- St John's Wort
Using netupitant and palonosetron 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.
Interactions with Food/Tobacco/Alcohol
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 netupitant and palonosetron 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.
Netupitant and palonosetron should come with a patient information leaflet. Read and follow the instructions carefully. Ask your doctor if you have any questions.
Take netupitant and palonosetron with or without food.
The dose of netupitant and palonosetron 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 netupitant and palonosetron. 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.
- For prevention of nausea and vomiting caused by chemotherapy:
If you miss a dose of netupitant and palonosetron, 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.
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.
Netupitant and palonosetron 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 netupitant and palonosetron.
Netupitant and palonosetron 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.
This Medicine Side Effects
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
- hearing or seeing things that are not there
- muscle twitching
- overactive reflexes
- poor coordination
- 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:
- unusual tiredness or weakness
- flushing or redness of the skin
- 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.
See also: Side effects (in more detail)
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