Supportive Oncology / Antiemetic

Akynzeo (netupitant and palonosetron hydrochloride)

Helsinn / Eisai · NK1 + 5-HT3 Receptor Antagonist Combination Antiemetic

FDA Approved 2014 Oral capsule Specialty Medication
Akynzeo netupitant palonosetron 300mg/0.5mg capsules, Helsinn Eisai, combination antiemetic for CINV

What is Akynzeo? Akynzeo (netupitant/palonosetron) is a fixed-dose combination of an NK1 receptor antagonist (netupitant) and a 5-HT3 antagonist (palonosetron) in a single oral capsule, approved for prevention of acute and delayed CINV from highly and moderately emetogenic chemotherapy.

About Akynzeo

Brand NameAkynzeo
Generic / INNnetupitant and palonosetron hydrochloride
Drug ClassNK1 + 5-HT3 Receptor Antagonist Combination Antiemetic
ManufacturerHelsinn / Eisai
AdministrationOral capsule
FDA Approval2014
📦 300 mg netupitant / 0.5 mg palonosetron per capsule (palonosetron equivalent to 0.5 mg base). An IV formulation (Aloxi/netupitant IV — Akynzeo IV) is also available.

FDA-Approved Uses for Akynzeo

Indications are based on FDA approval. Your healthcare provider determines appropriate use based on your specific diagnosis, stage, biomarker status, and overall clinical picture.

  • Prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy (HEC)
  • Prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of moderately emetogenic chemotherapy (MEC)

How Does Akynzeo Work?

Netupitant (NK1 antagonist) blocks substance P binding at NK1 receptors in the brain — preventing delayed CINV. Palonosetron (5-HT3 antagonist) blocks serotonin-mediated acute CINV. The combination targets both pathways in a single convenient capsule, administered once before chemotherapy.

Dosage & Administration

One capsule (netupitant 300 mg / palonosetron 0.5 mg) orally, 1 hour before chemotherapy. Used with dexamethasone (12 mg for HEC; 8 mg for MEC) per CINV guidelines. Single dose per chemotherapy cycle.

⚠️ Important

Dosing is individualized by the prescribing clinician. Never adjust your dose without consulting your healthcare provider. This information is educational only and does not replace the official prescribing information.

Warnings, Precautions & Side Effects

General Warning

CYP3A4 drug interactions (netupitant is a moderate CYP3A4 inhibitor). QT prolongation risk. Serotonin syndrome with concomitant serotonergic agents. Avoid in severe hepatic or renal impairment.

⛔ Serious Warnings & Precautions
  • CYP3A4 drug interactions
  • QT prolongation
  • Serotonin syndrome

Common Side Effects

  • Headache
  • Fatigue
  • Constipation
  • Dizziness

This is not a complete list. Always report new or worsening symptoms to your healthcare provider promptly.

Storage & Handling

Store at room temperature 25°C (77°F). Keep in original blister packaging.

BiologicHealthPlus provides temperature-monitored cold-chain specialty delivery for medications requiring refrigeration. Never use a medication if its storage conditions have been compromised.

Insurance Coverage, Prior Authorization & Patient Assistance

🛡️ Commercial Insurance

Akynzeo is covered by most major commercial insurance plans when medically necessary and prior authorized. Coverage tier and cost-sharing vary by plan.

✅ Prior Authorization

Prior authorization is required by virtually all insurance plans for Akynzeo. BiologicHealthPlus handles the complete prior authorization process at no cost to patients or providers.

🏥 Medicare Coverage

Medicare Part D covers this oral specialty medication. Medicaid coverage varies by state.

🆓 Patient Assistance

Manufacturer patient assistance programs may be available for eligible uninsured or underinsured patients. Contact BiologicHealthPlus for a confidential eligibility review.

Prior Authorization Patient Assistance Insurance & Savings Medication Costs

Frequently Asked Questions — Akynzeo

Akynzeo is a single oral capsule combining netupitant (NK1 antagonist) and palonosetron (5-HT3 antagonist) for prevention of CINV. It targets both the acute and delayed phases of chemotherapy-induced nausea in one convenient dose.

Akynzeo combines both mechanisms in one capsule taken once. Aprepitant (Emend) is a 3-day regimen combined with a separate 5-HT3 antagonist. Akynzeo simplifies the regimen to a single pre-chemotherapy dose.

Akynzeo is covered by most commercial insurance plans and Medicare Part D with prior authorization.

Related Medications

Aprepitant (Emend)  ·  Aloxi (palonosetron)  ·  Ondansetron  ·  Dexamethasone

Related Conditions

Chemotherapy-induced nausea and vomiting (CINV)  ·  Highly emetogenic chemotherapy

Comparisons

Aprepitant Palonosetron

Authoritative References

Medical Disclaimer: This page is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult your oncologist, hematologist, or licensed healthcare professional before making any treatment decisions. Last reviewed: August 2026 by the BiologicHealthPlus Clinical Team.