Can you take Akynzeo for Injection with Saxagliptin?

The palonosetron in Akynzeo for Injection has a moderate potential interaction with Liver Disease.

No dosage adjustment for palonosetron is necessary for patients with mild to moderate hepatic impairment (Child-Pugh score 5 to 8). Limited data are available in patients with severe hepatic impairment (Child-Pugh score greater than 9). It is recommended to avoid use of palonosetron in patients with severe hepatic impairment.

The fosnetupitant in Akynzeo for Injection has a moderate potential interaction with Liver Disease.

Limited data are available with fosnetupitant (only available in combination with palonosetron in the US) in patients with severe hepatic impairment (Child-Pugh score greater than 9), therefore, its use should be avoided in these patients. No dosage adjustment is necessary for patients with mild to moderate hepatic impairment (Child-Pugh score 5 to 8).

sAXagliptin has a moderate potential interaction with Pancreatitis.

There have been postmarketing reports of acute pancreatitis in patients taking DPP-4 inhibitors. These drugs should be used with caution in patients with a history of pancreatitis or pancreatic disease, although it is unknown if they are at increased risk. Patients should be observed for signs and symptoms of pancreatitis during treatment. If pancreatitis is suspected, treatment should be discontinued immediately and appropriate management should be initiated.

The palonosetron in Akynzeo for Injection has a moderate potential interaction with Renal Dysfunction.

Mild to moderate renal impairment does not significantly affect palonosetron pharmacokinetic parameters. However, total systemic exposure increased approximately 28% in patients with severe renal impairment. Additionally, the pharmacokinetics of palonosetron have not been studied in patients with end-stage renal disease. Caution is advised.

The fosnetupitant in Akynzeo for Injection has a moderate potential interaction with Renal Dysfunction.

No dosage adjustment for netupitant/fosnetupitant (only available in combination with palonosetron in the US), is necessary in patients with mild to moderate renal impairment (creatinine clearance of 30 to 60 mL/min). The pharmacokinetics and safety of netupitant/fosnetupitant have not been studied in patients with severe renal impairment. Severe renal impairment (creatinine clearance < 30 mL/min) did not substantially affect pharmacokinetics of palonosetron. The pharmacokinetics for netupitant and palonosetron were not studied in patients with end-stage renal disease requiring hemodialysis, therefore, avoid the use of this drug in patients with severe renal impairment or end-stage renal disease.

sAXagliptin has a moderate potential interaction with Renal Dysfunction.

It is recommended to assess renal function prior to initiating treatment with DPP-4 inhibitors and periodically thereafter. Patients with moderate to severe renal insufficiency and end stage renal dysfunction will require a dose adjustment. Linagliptin will not require a dose adjustment per manufacturer's information. Additionally, there have been postmarketing reports of worsening renal function in some patients with renal insufficiency taking sitagliptin at inappropriate doses.