Akynzeo (netupitant and palonosetron), Cost, Side Effects, Dosage, Copay And PI | Kunchok Dolma, PharmD | RxEconsult
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Akynzeo (netupitant and palonosetron), Cost, Side Effects, Dosage, And Prescribing Information For Chemotherapy Induced Nausea And Vomiting (CINV) Category: Cancer by - November 7, 2014 | Views: 27199 | Likes: 0 | Comment: 0  

What are side effects of Akynzeo?

Common side effects of Akynzeo include:

  • erythema (redness)
  • constipation
  • indigestion
  • headache
  • fatigue

Serious side effects of Akynzeo include: 

  • serious allergic reactions
  • serotonin syndrome (mental status changes, dizziness, diaphoresis, flushing, tremor, rigidity, seizures, vomiting and diarrhea)

What is the dosage of Akynzeo?

Akynzeo is available as a capsule containing 300 mg of netupitant and 0.5 mg palonosetron. Akynzeo can be taken without regards to meals.

Highly Emetogenic Chemotherapy (Cisplatin-based Chemotherapy)

Take one capsule of Akynzeo 1 hour prior to the start of chemotherapy with dexamethasone 12 mg administered orally 30 minutes prior to chemotherapy on day 1 and 8 mg orally once daily on days 2 to 4.

Not Highly Emetogenic Chemotherapy (Anthracyclines and Cyclophosphamide based Chemotherapy)

Take one capsule of Akynzeo approximately 1 hour prior to the start of chemotherapy plus dexamethasone 12 mg administered orally 30 minutes prior to chemotherapy on day 1.

What are Akynzeo drug interactions?

Some possible drug-drug interactions associated with Akynzeo:

Netupitant, a component of Akynzeo, blocks the activity of CYP3A4 liver enzymes which break down many drugs. Therefore, Akynzeo may increase the serum levels of the following drugs and other drugs that are broken down by CYP3A4 liver enzymes:

  • dexamethasone
  • midazolam
  • alprazolam
  • triazolam
  • docetaxel
  • paclitaxel
  • etoposide
  • irinotecan
  • cyclophosphamide
  • ifosfamide
  • imatinib
  • vinorelbine
  • vinblastine
  • vincristine

Netupitant, a component of Akynzeo, is broken down by CYP3A4 liver enzymes. Drugs (for example, ketoconazole) that reduce the effect of CYP3A4 liver enzymes may increase blood levels of netupitant. Conversely, drugs such as rifampin that increase the activity of CYP3A4 liver enzymes may reduce blood levels of netupitant. 

Combining Akynzeo with serotonergic drugs such as serotonin reuptake inhibitors (SSRIs), serotonin and noradrenaline reuptake inhibitors (SNRIs), monoamine oxidase inhibitors, mirtazapine, fentanyl, lithium, tramadol and intravenous methylene blue increase the risk of serotonin syndrome.  

What are warnings and precautions for Akynzeo?

  • Hypersensitivity reactions, including anaphylaxis, have been reported with Akynzeo.
  • Akynzeo may cause serotonin syndrome. 

Pregnancy: Akynzeo has not been adequately evaluated in pregnant women.

Nursing mother: It is not known if Akynzeo is excreted in human milk.

What is the cost of Akynzeo?

The average wholesale price of one capsule of Akynzeo is about $474. The retail price is between $570 to $590 per capsule. 

How to obtain prescription assistance for Akynzeo?

For obtaining prescription assistance visit the Akynzeo Savings Program for the Akynzeo copay card that assists patients with a $0 copay on each prescription. 

References

Akynzeo Prescribing Information (PI)

Akynzeo Patient Education Monograph

 


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