# Netupitant and palonosetron

Source: https://onco.cc/drugs/netupitant-palonosetron/  
OnCo record `netupitant-palonosetron` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Akynzeo combines two anti-sickness drugs in one capsule or infusion taken once before chemotherapy, so a single dose plus dexamethasone protects against both immediate and delayed vomiting.

## Summary

Netupitant/palonosetron was approved by the FDA in October 2014 for prevention of acute and delayed nausea and vomiting with initial and repeat courses of chemotherapy including highly emetogenic regimens, in combination with dexamethasone, on phase 3 trials against palonosetron alone in cisplatin and anthracycline-cyclophosphamide regimens in which complete response over five days was higher, a statistically significant difference; the intravenous fosnetupitant/palonosetron formulation followed in 2018. The EU authorised Akynzeo in 2015. It simplifies the guideline-recommended triple regimen to one antiemetic product plus a steroid. Headache, asthenia and constipation are the main adverse effects; netupitant is a moderate CYP3A4 inhibitor.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-10
- Also known as: NEPA; Fosnetupitant and palonosetron (intravenous)
- Tags: nci-list; supportive
- Brand: Akynzeo
- Modality: Fixed combination NK1 antagonist plus 5-HT3 antagonist (antiemetic)
- Mechanism: Netupitant, a long-acting substance P/NK1 receptor antagonist, blocks delayed emesis while palonosetron, a 5-HT3 antagonist, covers the acute phase; a single capsule or infusion with dexamethasone.
- Approvals: US 2014: Acute and delayed chemotherapy-induced nausea and vomiting including highly emetogenic regimens, with dexamethasone (intravenous form 2018); EU 2015: Acute and delayed nausea and vomiting with highly and moderately emetogenic chemotherapy (Akynzeo)

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Netupitant/palonosetron
- US label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=netupitant
- NCI drug page: https://www.cancer.gov/about-cancer/treatment/drugs/netupitant-palonosetronhydrochloride
- EPAR: https://www.ema.europa.eu/en/medicines/human/EPAR/akynzeo

## Connected records

- drugs: [Aprepitant (and fosaprepitant)](https://onco.cc/drugs/aprepitant/), [Palonosetron](https://onco.cc/drugs/palonosetron/), [Rolapitant](https://onco.cc/drugs/rolapitant/)
- technologies: [Antiemetics for chemotherapy-induced nausea and vomiting](https://onco.cc/technologies/antiemetic-therapy/)
- companies: [Helsinn](https://onco.cc/companies/helsinn/)
- trials: [AKY15-HK-301_NEPA Study](https://onco.cc/trials/nct03386617/), [Safety and Antiemetic Efficacy of Akynzeo Plus Dexamethasone During Radiotherapy and Concomitant Weekly Cisplatin](https://onco.cc/trials/nct03668639/), [Treatment of Refractory Nausea and Vomiting in Patients With Breast Cancer](https://onco.cc/trials/nct03367572/)
- targets: [NK1 receptor (TACR1)](https://onco.cc/targets/tacr1/)

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JSON: https://onco.cc/api/v1/entities/netupitant-palonosetron.json