netupitant + palonosetron hydrochloride at a glance
Medicine class
Combined NK1-receptor and 5-HT3-receptor antagonist antiemetic
Usual role
Prevention of acute and delayed chemotherapy-induced nausea and vomiting in adults
Administration
Swallow the hard capsule whole; it may be taken with or without food.
Driving
Do not drive or use machinery if dizziness, sleepiness or fatigue occurs.
What is netupitant + palonosetron hydrochloride used for?
The capsule is licensed in adults to prevent:
Acute and delayed nausea and vomiting associated with highly emetogenic cisplatin-based cancer chemotherapy.
Acute and delayed nausea and vomiting associated with moderately emetogenic cancer chemotherapy.
How does netupitant + palonosetron hydrochloride work?
Chemotherapy can trigger serotonin-mediated vomiting early and substance P-mediated vomiting later. Palonosetron blocks 5-HT3 receptors involved in the vomiting reflex, while netupitant blocks substance P at NK1 receptors; together they cover both pathways.
netupitant + palonosetron hydrochloride preparations and strengths
Capsule
Route: Oral
Strengths: 300 mg + 0.5 mg
How to take netupitant + palonosetron hydrochloride
Follow the chemotherapy team's instructions. The capsule may be taken with or without food.
Swallow the capsule whole.
Do not open, crush or divide it.
Tell the oncology team about all prescription, non-prescription and herbal products before taking it.
netupitant + palonosetron hydrochloride side effects
Common or expected effects
- Headache
- Constipation
- Fatigue
Get urgent medical advice
- Severe allergic reaction, including hives, facial or throat swelling, breathing difficulty, low blood pressure or collapse
- Serotonin syndrome, with possible agitation, sweating, fever, tremor or muscle stiffness
- Severe constipation or suspected bowel obstruction
- Fainting, sustained palpitations or other concerning heart-rhythm symptoms
netupitant + palonosetron hydrochloride in pregnancy
The capsule is contraindicated during pregnancy because human data are lacking and netupitant caused reproductive harm in animal studies. Pregnancy should be excluded before treatment in pre-menopausal women. Discuss contraception or possible pregnancy promptly with the oncology team.
netupitant + palonosetron hydrochloride while breastfeeding
It is unknown whether either component enters human milk, and risk to a breastfed child cannot be excluded. The product information advises stopping breastfeeding during treatment; seek specialist advice when planning feeding.
netupitant + palonosetron hydrochloride interactions
Netupitant is a CYP3A4 substrate and moderate inhibitor, so clinically important interactions are possible.
Dexamethasone
Netupitant increases dexamethasone exposure, so the oncology prescriber must adjust the antiemetic plan accordingly.
Strong CYP3A4 inducers, such as rifampicin
They can lower netupitant exposure and reduce anti-sickness efficacy; concomitant use should be avoided.
Strong CYP3A4 inhibitors, such as ketoconazole
They can increase netupitant exposure, requiring clinical caution.
Common questions about netupitant + palonosetron hydrochloride
Answers are fully visible for fast scanning and source review.
What is netupitant + palonosetron hydrochloride used for?
It is licensed in adults to prevent acute and delayed nausea and vomiting caused by highly emetogenic cisplatin-based or moderately emetogenic cancer chemotherapy.
Does netupitant + palonosetron hydrochloride treat sickness after it has started?
Its licensed role is prevention rather than rescue treatment. Breakthrough nausea or vomiting should be reported to the oncology team so they can advise on appropriate additional treatment.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.