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Generic Name: netupitant and palonosetron (oral) (net UE pi tant and PAL oh NOE se tron)
Brand Names: Akynzeo
Akynzeo (netupitant and palonosetron) is used to treat chemotherapy-induced nausea and vomiting. Includes Akynzeo side effects, interactions and indications.
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Drug Information:
Akynzeo contains a combination of netupitant and palonosetron. Akynzeo is used to help prevent nausea and vomiting caused by chemotherapy. This medicine is given together with a steroid called dexamethasone. Akynzeo helps prevent nausea and vomiting that occurs both during chemotherapy and later on (delayed nausea and vomiting). Before you take Akynzeo, tell your doctor if you are pregnant or plan to become pregnant. Netupitant and palonosetron may harm your unborn baby. Tell your doctor if you are breastfeeding or plan to breastfeed. You and your doctor should decide if you will take Akynzeo or breastfeed. You should not do both. Learn more

Akynzeo Side Effects

Akynzeo Side Effects

Note: This document contains side effect information about netupitant / palonosetron. Some of the dosage forms listed on this page may not apply to the brand name Akynzeo.

For the Consumer

Applies to netupitant/palonosetron: oral capsule

Along with its needed effects, netupitant / palonosetron may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking netupitant / palonosetron:

Incidence not known

  • Agitation
  • confusion
  • dizziness
  • fever
  • hearing or seeing things that are not there
  • muscle twitching
  • overactive reflexes
  • poor coordination
  • shivering
  • sweating
  • trembling or shaking

Some side effects of netupitant / palonosetron may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

  • Headache
  • fatigue
  • unusual tiredness or weakness

Less common

  • constipation
  • flushing or redness of the skin
  • heartburn
  • indigestion
  • stomach discomfort, upset, or pain

For Healthcare Professionals

Applies to netupitant / palonosetron: oral capsule


Common (1% to 10%): Constipation, dyspepsia

Uncommon (0.1% to 1%): Abdominal distention, abdominal pain, diarrhea, flatulence, nausea

Rare (0.01% to 0.1%): Dysphagia, tongue coated


Common (1% to 10%): Constipation, dyspepsia

Nervous system

Common (1% to 10%): Headache

Uncommon (0.1% to 1%): Dizziness, vertigo

Rare (0.01% to 0.1%): Abnormal taste, hypoesthesia


Common (1% to 10%): Headache


Common (1% to 10%): Erythema

Uncommon (0.1% to 1%): Alopecia, urticaria


Common (1% to 10%): Erythema


Uncommon (0.1% to 1%): Insomnia

Rare (0.01% to 0.1%): Acute psychosis, altered mood, sleep disorder


Common (1% to 10%): Asthenia, fatigue


Common (1% to 10%): Asthenia, fatigue

Rare (0.01% to 0.1%): Feeling hot


Uncommon (0.1% to 1%): Fatigue


Uncommon (0.1% to 1%): Atrioventricular (AV) block, AV block first degree, bundle branch block, cardiomyopathy, conduction disorder, electrocardiogram QT prolonged, hypertension

Rare (0.01% to 0.1%): Arrhythmia, AV block second degree, electrocardiogram ST segment depression, electrocardiogram ST-T segment abnormal, hypotension, increased troponin, mitral valve incompetence, myocardial ischemia, ventricular extrasystoles


Postmarketing reports: Shock


Approximately 0.6% of patients given 0.5 mg of palonosetron developed AST greater than 3 times the upper limit of normal (ULN) and/or ALT greater than 3 x ULN with total bilirubin greater than ULN. Approximately 0.2% of patients given the same dose of palonosetron developed AST greater than 10 x ULN and/or ALT greater than 10 x ULN with total bilirubin greater than ULN, and approximately 0.1% of patients developed AST greater than 3 x ULN and/or ALT greater than 3 x ULN with total bilirubin greater than or equal to 2 x ULN.

Approximately 0.3% of patients given oral formulations of netupitant-palonosetron developed AST greater than 3 x ULN and/or ALT greater than 3 x ULN with total bilirubin greater than ULN, and AST greater than 3 x ULN and/or ALT greater than 3 x ULN with total bilirubin greater than or equal to 2 x ULN occurred in up to 0.1% of patients.

Uncommon (0.1% to 1%): Elevated ALT, elevated AST, elevated total bilirubin, increased blood alkaline phosphatase

Rare (0.01% to 0.1%): Increased blood bilirubin


Uncommon (0.1% to 1%): Elevated AST, elevated ALT, elevated total bilirubin


Uncommon (0.1% to 1%): Leukocytosis, neutropenia

Rare (0.01% to 0.1%): Leukopenia, lymphocytosis


Uncommon (0.1% to 1%): Increased blood creatine phosphokinase

Rare (0.01% to 0.1%): Back pain, non-cardiac chest pain


Uncommon (0.1% to 1%): Myalgia


Rare (0.01% to 0.1%): Blurred vision, conjunctivitis


Uncommon (0.1% to 1%): Eye swelling


Uncommon (0.1% to 1%): Decreased appetite

Rare (0.01% to 0.1%): Hypokalemia


Uncommon (0.1% to 1%): Increased blood creatinine

Rare (0.01% to 0.1%): Cystitis


Uncommon (0.1% to 1%): Hiccups


Frequency not reported: Dyspnea



Postmarketing reports: Anaphylactic/anaphylactoid reactions, anaphylaxis

Editorial References and Review

Medically reviewed by BestRx Medical Team Last updated on 1/1/2020.

Source: Drugs.com Akynzeo