Netupitant and palonosetron

Netupitant and palonosetron is used along with other medications to stop nausea and vomiting that may occur during and after chemotherapy in adults.

Netupitant and palonosetron is not used to treat nausea and vomiting that you already have.

Netupitant and palonosetron may also be used for reasons not mentioned in this medication guide.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.

You may take netupitant and palonosetron with or without food 1 hour before the start of chemotherapy.

You may be given other medications to help prevent nausea and vomiting. Keep taking these medicines for as long as your doctor has prescribed.

You may need blood tests after receiving netupitant and palonosetron if you also take a blood thinner called warfarin.

Store at room temperature away from moisture and heat.

Use only as directed. Inform your doctor if you are taking other medicines or have other medical conditions or allergies.

Tell your doctor if you have ever had:

• an allergic reaction to a similar medicine for nausea or vomiting, such as dolasetron, ondansetron, palonosetron, or granisetron; or
• severe liver or kidney disease.

Tell your doctor if you also use stimulant medicine, opioid medicine, herbal products, or medicine for depression, mental illness, Parkinson's disease, migraine headaches, serious infections, or prevention of nausea and vomiting. An interaction with netupitant and palonosetron could cause a serious condition called serotonin syndrome.

Netupitant and palonosetron may harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant.

Ask a doctor if it is safe to breastfeed while using netupitant and palonosetron.

Get emergency medical help if you have signs of an allergic reaction: hives, difficult breathing, swelling of your face, lips, tongue, or throat.

Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.

Common side effects of netupitant and palonosetron may include:

• headache;
• feeling weak or tired;
• skin redness; or
• upset stomach, constipation.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Usual Adult Dose for Nausea/Vomiting -- Chemotherapy Induced:

Netupitant 300 mg-palonosetron 0.5 mg orally ONCE, given 60 minutes before chemotherapy on Day 1ADDITIONAL MEDICATIONS:Highly Emetogenic Cancer Chemotherapy, Including Cisplatin-Based Chemotherapy:-Day 1: Dexamethasone 12 mg orally 30 minutes prior to chemotherapy-Days 2 to 4: Dexamethasone 8 mg orally once a dayAnthracyclines and Cyclophosphamide-Based Chemotherapy and Chemotherapy Not Considered Highly Emetogenic:-Day 1: Dexamethasone 12 mg orally 30 minutes prior to chemotherapyUse: In combination with dexamethasone for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of cancer chemotherapy, including, but not limited to, highly emetogenic chemotherapy

Call your doctor for instructions if you miss a dose.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Sometimes it is not safe to use certain medicines together. Some drugs can change the levels of other drugs in your blood, which may increase side effects or make the medicines less effective.

Many drugs can affect netupitant and palonosetron. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all other medicines you take.