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Fosnetupitant / Palonosetron Dosage

Medically reviewed by Last updated on Oct 12, 2022.

Applies to the following strengths: 235 mg-0.25 mg

Usual Adult Dose for Nausea/Vomiting - Chemotherapy Induced

Fosnetupitant 235 mg-palonosetron 0.25 mg via IV infusion over 30 minutes ONCE, starting 30 minutes before chemotherapy on Day 1

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

Use: In combination with dexamethasone for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer 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.



Safety and efficacy have not been established in patients younger than 18 years.

Consult WARNINGS section for additional precautions.


End-stage renal disease requiring hemodialysis: Not recommended.
Peritoneal dialysis: Data not available

Other Comments

Administration advice:

  • The infusion line should be flushed with 0.9% sodium chloride at the prior to and at the end of the infusion to ensure complete administration.
  • Other IV substances, additives, or other medications should not be added to the solution or infused simultaneously.

Storage requirements:
  • Reconstitution to the start of infusion should not go beyond 3 hours.
  • Prior to reconstitution, vials should be stored at 2 to 8C and protected from light.
  • Reconstituted solutions and final diluted solutions should be stored at room temperature.

Reconstitution/preparation techniques:
  • The manufacturer product information should be consulted.

IV compatibility:
  • Incompatible: Solutions containing divalent cations (e.g., calcium, magnesium), Lactated Ringer's Injection, Hartmann's Solution
  • Unknown: Other IV substances, additives, other medications

  • LIMITATION OF USE: This drug has not been studied for the prevention of nausea/vomiting associated with anthracycline PLUS cyclophosphamide chemotherapy.

  • 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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.