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Fosnetupitant and palonosetron (injection)

Generic name: fosnetupitant and palonosetron (injection) [ FOS-net-UE-pi-tant-and-PAL-oh-NOE-se-tron ]
Brand names: Akynzeo for Injection, Akynzeo Injection
Dosage form: intravenous powder for injection (235 mg-0.25 mg)
Drug class: Miscellaneous antiemetics

Medically reviewed by on Oct 12, 2023. Written by Cerner Multum.

What is fosnetupitant and palonosetron?

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

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

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

Fosnetupitant and palonosetron side effects

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, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects of fosnetupitant and palonosetron may include:

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.


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.

Before taking this medicine

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

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 fosnetupitant and palonosetron and cause a serious condition called serotonin syndrome.

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

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

How is fosnetupitant and palonosetron given?

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

About 30 minutes before chemotherapy, a healthcare provider will give you fosnetupitant and palonosetron as an infusion into a vein.

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

Fosnetupitant and palonosetron dosing information

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

What happens if I miss a dose?

Fosnetupitant and palonosetron is used as a single injection and does not have a daily dosing schedule.

What happens if I overdose?

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

What should I avoid while receiving fosnetupitant and palonosetron?

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

What other drugs will affect fosnetupitant and palonosetron?

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 fosnetupitant 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.

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

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