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Overview: Akynzeo is a combination antiemetic that is used to prevent nausea and vomiting due to chemotherapy. Akynzeo comes as a capsule that you swallow or as a liquid that is injected into a vein (IV). Common side effects include headache, upset stomach, and tiredness. Serious side effects may include serotonin syndrome, especially if Akynzeo is used with certain other medicines. Tell your health care provider about all the medicines you take before starting Akynzeo.

Uses

What is Akynzeo used for?

Akynzeo (netupitant/palonosetron) is commonly used to prevent nausea and vomiting that is caused by certain cancer treatments (chemotherapy).

Akynzeo may also be used for other conditions as determined by your health care provider.

How does Akynzeo work (mechanism of action)?

Akynzeo is an antiemetic (antinausea medicine) that contains two medicines, netupitant and palonosetron. Both medicines work by targeting certain receptors in the body, which helps prevent nausea and vomiting from chemotherapy that can happen right away or may be delayed. 

Netupitant is a substance P/neurokinin-1 (NK-1) receptor antagonist. It works by preventing a substance in the brain from binding to NK-1 receptors, which helps suppress the vomiting reflex. 

Palonosetron is a 5-HT3 (serotonin) receptor antagonist. When the body is exposed to chemotherapy, it may make more serotonin, which can lead to nausea and vomiting. Palonosetron works by blocking 5-HT3 (serotonin) receptors in the gut and brain, which can help prevent nausea and vomiting.

The injectable form of Akynzeo contains fosnetupitant instead of netupitant. Fosnetupitant turns into netupitant in the body. Netupitant is the same ingredient as that present in Akynzeo capsules that are taken by mouth. 

How is Akynzeo supplied (dosage forms)?

Brands and other names

  • Akynzeo

Dosage forms and strengths

  • 300 mg/0.5 mg oral capsules

Akynzeo is also available in an injectable form that is given by a health care provider. 

How should I store Akynzeo?

Oral Capsule. Akynzeo capsule should be stored at room temperature, between 68 F and 77 F (20 C and 25 C). It can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Injection Liquid. Akynzeo injection is usually given by a health care provider in a hospital or clinic. You will not store it at home.

Side Effects

What are the most common side effects of Akynzeo?

The most common side effects of Akynzeo are listed below. Tell your health care provider if you have any of these side effects that bother you.

  • Headache
  • Weakness
  • Upset stomach
  • Tiredness
  • Constipation
  • Skin redness or discoloration

There may be other side effects of Akynzeo that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of Akynzeo?

While less common, the most serious side effects of Akynzeo are described below, along with what to do if they happen.

Severe Allergic Reactions. Akynzeo may cause allergic reactions, which can be serious. Stop using Akynzeo and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Akynzeo can cause serotonin syndrome when it is used alone or with other medicines that affect serotonin. This condition can be life-threatening. Get emergency help if you have any of the following symptoms of serotonin syndrome.

  • Sweating, fever, or flushing
  • Confusion
  • Feeling agitated or restless
  • Seeing or hearing unusual things
  • Dizziness
  • Fast or racing heartbeat
  • Nausea, vomiting, or diarrhea
  • Muscle twitching, stiffness, or tremor

Warnings & Precautions

Who should not use Akynzeo?

Allergies to Ingredients. People who are allergic to any of the following should not use Akynzeo.

  • Akynzeo
  • Fosnetupitant
  • Netupitant
  • Palonosetron
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in Akynzeo.

What should I know about Akynzeo before using it?

Akynzeo comes as either an injection given by a health care provider into a vein (IV) or as a capsule that you take by mouth. Do not use Akynzeo unless it has been prescribed to you by a health care provider. Use it as prescribed.

Do not share Akynzeo with other people, even if they have the same condition as you. It may harm them.

Keep Akynzeo out of the reach of children.

Read and follow the instructions for Akynzeo and make sure you understand how to prepare and take it properly. Your health care provider will tell you exactly how to use this medicine. Usually, if you are taking Akynzeo capsules, you will take the medicine one hour before you receive your chemotherapy. If you have any questions, talk to your health care provider.

What should I tell my health care provider before using Akynzeo?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if Akynzeo is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

  • Liver problems
  • Kidney problems

Other Medicines and Supplements. Akynzeo may interact with other medicines and supplements. Before using Akynzeo, tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. Akynzeo may cause harm to a fetus. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if Akynzeo passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed. Your health care provider will let you know if you should use Akynzeo while breastfeeding.

How can I get more information about Akynzeo?

For more information about Akynzeo, you can visit the drugmaker’s website at www.akynzeo.com or call them at 844-357-4668.

Interactions

Does Akynzeo interact with foods or drinks?

There are no known interactions between Akynzeo and foods or drinks.

 It is unknown if drinking alcohol will affect Akynzeo.

Does Akynzeo interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

 

In particular, make sure that you discuss if you are using any of the following before using Akynzeo.

  • A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline, which is a medicine commonly used for anxiety and depression
  • A serotonin and norepinephrine reuptake inhibitor (SNRI), such as duloxetine or venlafaxine, which is a medicine commonly used for anxiety and depression
  • A monoamine oxidase inhibitor (MAOI), which is a medicine usually used for depression or Parkinson’s disease
  • Mirtazapine (Remeron, Remeron Soltab), which is a medicine commonly used for depression
  • Lithium, which is a medicine for certain mental health conditions
  • Any other medicine used to treat or prevent nausea and vomiting, such as granisetron (Sancuso, Sustol), ondansetron, or palonosetron (Posfrea)
  • An opioid, such as fentanyl or tramadol, which is a medicine used to treat certain types of pain
  • Any medicine used to treat migraine
  • A corticosteroid, such as dexamethasone, which is a medicine for certain inflammatory conditions
  • A benzodiazepine, such as alprazolam or triazolam, which is a medicine used for anxiety, muscle spasms, or seizures
  • Any medicine used to treat cancer
  • Ketoconazole, which is a medicine used for fungal infections
  • Rifampin (Rifadin), which is a medicine commonly used to treat an infection called tuberculosis

Many other medicines may alter the blood levels of Akynzeo, and vice versa. Tell your health care provider about all medicines that you take or have recently taken.

This may not be a complete list of medicines that can interact with Akynzeo. Always check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much Akynzeo?

If you or someone else has used too much Akynzeo, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of Akynzeo?

You will usually take your dose of Akynzeo before receiving your cancer treatment. Tell your health care provider right away if you forget to take your dose before you start receiving your cancer treatment.