Akynzeo Patient Counseling
Counsel patients to take Akynzeo capsules approximately 1 hour before chemotherapy starts, with or without food, and emphasize that this single dose provides complete antiemetic coverage for both acute and delayed nausea without requiring additional doses on subsequent days. 1
Timing and Administration
- Take Akynzeo exactly 1 hour prior to chemotherapy initiation, regardless of whether food is consumed 1
- Swallow the capsule whole with water; do not open, crush, or chew the capsule 1
- If difficulty swallowing occurs, discuss with the healthcare provider immediately, as opening the capsule may affect the intended delivery mechanism (though efficacy has been maintained in limited cases when contents were administered separately) 2
- For IV formulation, the medication will be administered over 30 minutes before chemotherapy 1
Key Advantages of Single-Dose Therapy
- One dose provides complete protection for both immediate (acute) and delayed nausea/vomiting that can occur over the next 5 days after chemotherapy 3, 4
- Unlike other antiemetic regimens requiring multiple daily doses, Akynzeo's fixed combination eliminates the need for additional antiemetic pills on days 2-5 5, 3
- The medication combines two mechanisms (NK1 receptor antagonist netupitant and 5-HT3 receptor antagonist palonosetron) in a single capsule 3, 4
Critical Safety Warnings
Hypersensitivity Reactions
- Seek immediate medical attention if signs of allergic reaction develop, including rash, hives, difficulty breathing, swelling of face/lips/tongue/throat, or anaphylaxis 1
Serotonin Syndrome
- Report immediately if experiencing: changes in mental status (confusion, agitation), rapid heart rate, high blood pressure, fever, excessive sweating, tremors, muscle rigidity, or coordination problems 1
- Particularly important if taking antidepressants (SSRIs, SNRIs), migraine medications (triptans), or other serotonergic drugs 1
Pregnancy and Breastfeeding Considerations
- Inform your oncologist immediately if you are pregnant, planning pregnancy, or suspect pregnancy, as Akynzeo may cause fetal harm 1
- Do not breastfeed while taking Akynzeo; discuss with your provider whether to discontinue breastfeeding or avoid the medication 1
Drug Interactions to Report
- Inform your healthcare team about all medications, including prescription drugs, over-the-counter medications, vitamins, and herbal supplements, as Akynzeo can interact with many medications 1
- Particularly important to disclose: antidepressants, migraine medications, blood thinners (warfarin), certain antibiotics, antifungals, and medications metabolized by CYP3A4 1
Expected Effectiveness
- Over 90% of patients achieve complete control of nausea and vomiting (no vomiting and no need for rescue medications) throughout the entire at-risk period when Akynzeo is combined with dexamethasone 3, 4, 6
- Effectiveness is maintained across multiple chemotherapy cycles 3, 4
- Works for both highly emetogenic chemotherapy (like cisplatin) and moderately emetogenic chemotherapy (like anthracycline-cyclophosphamide combinations) 4, 6
Common Side Effects
- Most common adverse events include headache and constipation, which are typically mild 7, 3
- Adverse events occur in less than 4% of patients 6
- No cardiac safety concerns have been identified 4
What to Do If Nausea Occurs Despite Akynzeo
- Contact your oncology team immediately if breakthrough nausea or vomiting occurs despite taking Akynzeo as prescribed 1
- Rescue medications from different drug classes may be added rather than repeating Akynzeo 7
- Your antiemetic regimen may need adjustment for subsequent chemotherapy cycles 8
Storage Instructions
- Store capsules at room temperature between 68°F to 77°F (20°C to 25°C) 1
- Keep in original packaging until use 1