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Combination of
NetupitantNK1 receptor antagonist
Palonosetron5-HT3 receptor antagonist
Trade namesAkynzeo
Clinical data
Main usesChemotherapy-induced nausea and vomiting[1]
Side effectsHeadache, constipation, tiredness[2]
Routes of
By mouth, intravenous
External links
US NLMNetupitant/palonosetron
License data
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only) [5]
  • US: ℞-only [6]
  • EU: Rx-only [2]
  • In general: ℞ (Prescription only)

Netupitant/palonosetron, sold under the brand name Akynzeo, is a combination medication for prevention of acute and delayed chemotherapy-induced nausea and vomiting.[1] It is taken by mouth.[1] It is used with dexamethasone.[1]

Common side effects include headache, constipation, and tiredness.[2] The dose does not need to be adjusted in those with mild to moderate liver or kidney problems.[1] Use is not recommended in pregnancy.[7] Netupitant is an NK1 receptor blocker and palonosetron is a 5-HT3 receptor blocker.[2]

The combination was approved for medical use in the United States in 2014 and Europe in 2015.[1][2] In the United Kingdom it costs the NHS about £70 a dose as of 2021.[7] In the United States this amount costs about 680 USD.[8]

Medical use


The typical dose is one capsule a hour before chemotherapy.[2] This contains 300 mg of netupitant and 0.5 mg of palonosetron.[1]

There is an intravenous version that contains fosnetupitant and palonosetron.[9][6]


Netupitant/palonosetron may be contraindicated during pregnancy.[10][3][4]

Side effects

The most common side effects include headache, weakness, fatigue, upset stomach, constipation, and skin redness.[6] The overall profile of adverse effects is comparable to that of palonosetron (see Palonosetron#Adverse effects); no common adverse effects can be attributed to netupitant.[10]




Netupitant/palonosetron was approved for use in the United States in October 2014.[11] It was approved for use in the European Union in May 2015.[2] The intravenous version was approved in the United States in April 2018.[12][9]


  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 "Netupitant/Palonosetron Monograph for Professionals". Retrieved 12 November 2021.
  2. 2.0 2.1 2.2 2.3 2.4 2.5 2.6 "Akynzeo EPAR". European Medicines Agency (EMA). 19 March 2020. Retrieved 19 March 2020.
  3. 3.0 3.1 3.2 "Netupitant / palonosetron (Akynzeo) Use During Pregnancy". 22 October 2018. Retrieved 19 March 2020.
  4. 4.0 4.1 "Fosnetupitant / palonosetron (Akynzeo for Injection) Use During Pregnancy". 22 October 2018. Retrieved 19 March 2020.
  5. "Akynzeo 300 mg/0.5 mg hard capsules - Summary of Product Characteristics (SmPC)". (emc). 11 February 2020. Retrieved 19 March 2020.
  6. 6.0 6.1 6.2 "Akynzeo- netupitant and palonosetron capsule Akynzeo- fosnetupitant and palonosetron injection". DailyMed. 28 May 2020. Retrieved 18 July 2020.
  7. 7.0 7.1 BNF 81: March-September 2021. BMJ Group and the Pharmaceutical Press. 2021. p. 456. ISBN 978-0857114105.
  8. "Akynzeo Prices, Coupons & Patient Assistance Programs". Retrieved 12 November 2021.
  9. 9.0 9.1 "Drug Trials Snapshots: Akynzeo". U.S. Food and Drug Administration (FDA). 11 May 2018. Retrieved 19 March 2020.
  10. 10.0 10.1 Haberfeld H, ed. (2015). Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag. Akynzeo 300 mg / 0,5 mg Hartkapseln.CS1 maint: unrecognized language (link)
  11. "Drug Approval Package: Akynzeo (Netupitant and Palonosetron) Capsules NDA #205718". U.S. Food and Drug Administration (FDA). 7 November 2014. Retrieved 19 March 2020.
  12. "Drug Approval Package: Akynzeo (fosnetupitant and palonosetron) Injection". U.S. Food and Drug Administration (FDA). 31 May 2018. Retrieved 19 March 2020.

External links