USES
Chemotherapy drugs work by targeting rapidly dividing cells, including cancer cells, but they can also affect healthy cells in the body, including those in the gastrointestinal tract and the brain’s vomiting center. This disruption often leads to nausea and vomiting, which can significantly impact a patient’s quality of life and may even lead to treatment discontinuation or dose reduction.
Postoperative nausea and vomiting (PONV) are common complications following surgery, affecting up to 30% of patients. Various factors contribute to PONV, including anesthetic agents, surgical procedure type, and patient-related factors such as age and history of motion sickness or PONV. PONV not only causes discomfort but can also lead to complications such as dehydration, electrolyte imbalances, and wound dehiscence.
By targeting the serotonin receptors in the brainstem and blocking the release of serotonin, Akynzeo helps to minimize the incidence and severity of nausea and vomiting after surgery. This provides patients with a more comfortable recovery experience and may reduce the need for rescue antiemetic medications, ultimately improving patient satisfaction and outcomes.
WORKING
Akynzeo combines two active ingredients, netupitant and palonosetron, which work synergistically to prevent nausea and vomiting.
Netupitant is a substance P/neurokinin-1 (NK-1) receptor antagonist. Substance P is a neurotransmitter that plays a key role in triggering nausea and vomiting in response to chemotherapy. By blocking the NK-1 receptors in the central nervous system, netupitant inhibits the action of substance P, thereby reducing the sensation of nausea and the urge to vomit.
Palonosetron is a selective serotonin (5-HT3) receptor antagonist. Serotonin is another neurotransmitter involved in the emetic response, particularly in the chemoreceptor trigger zone and gastrointestinal tract. Palonosetron selectively binds to and blocks the 5-HT3 receptors, preventing the activation of these receptors by serotonin. This action helps to inhibit the vomiting reflex and reduce the likelihood of nausea and vomiting.
SIDE EFFECTS
Common Side Effects:
- Headache: Mild to moderate headaches are a commonly reported side effect of Akynzeo.
- Constipation: Some individuals may experience constipation while taking Akynzeo.
- Fatigue: Feelings of tiredness or weakness may occur as a result of Akynzeo treatment.
- Weakness: Generalized weakness or fatigue may also be experienced by some patients.
Serious Side Effects:
- Allergic Reactions: In rare cases, individuals may experience allergic reactions to Akynzeo, characterized by symptoms such as rash, itching, swelling, dizziness, or difficulty breathing.
- Irregular Heartbeat: Akynzeo may cause changes in heart rhythm, leading to an irregular heartbeat or palpitations.
- Serotonin Syndrome: Taking Akynzeo in combination with other serotonergic medications may increase the risk of serotonin syndrome.
WARNINGS
Akynzeo may cause dizziness or drowsiness. Patients with a history of cardiac arrhythmias or QT prolongation should use Akynzeo with caution. Monitor for any signs or symptoms of irregular heartbeat, and inform your healthcare provider if you experience palpitations, chest pain, or fainting.
Patients with moderate to severe hepatic impairment may require dosage adjustments when taking Akynzeo. Consult your healthcare provider for personalized dosing recommendations based on your liver function.
The safety of Akynzeo during pregnancy and lactation has not been established. Discuss the potential risks and benefits with your healthcare provider before using Akynzeo if you are pregnant, planning to become pregnant, or breastfeeding.
If you have a known hypersensitivity or allergic reaction to any of the ingredients in Akynzeo, avoid using the medication and seek alternative antiemetic options.
The safety and efficacy of Akynzeo in pediatric patients have not been established. Use in this population should be guided by a healthcare provider’s assessment of the potential risks and benefits. Akynzeo may interact with other medications, including those metabolized by cytochrome P450 (CYP3A4) enzymes.
INTERACTIONS
Akynzeo may interact with other medications, potentially affecting their efficacy or increasing the risk of adverse effects. Some of the significant drug interactions associated with Akynzeo include:
Akynzeo is metabolized by cytochrome P450 3A4 (CYP3A4) enzymes. Concomitant use of strong CYP3A4 inhibitors, such as ketoconazole, itraconazole, clarithromycin, or ritonavir, may increase the plasma concentrations of netupitant and palonosetron, leading to an increased risk of adverse effects.
Dosage adjustments or alternative antiemetic options may be necessary in these cases. Avoid concomitant use of these medications or monitor for decreased antiemetic effects and consider alternative therapies if needed.
Combining Akynzeo with other serotonergic medications, such as selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants, triptans, or opioids, may increase the risk of serotonin syndrome, a potentially life-threatening condition characterized by symptoms such as agitation, hallucinations, rapid heart rate, and muscle rigidity.
DOSAGE
Akynzeo, indicated for chemotherapy-induced and postoperative nausea and vomiting prevention, typically comes in a single-capsule dose taken orally about an hour before chemotherapy or anesthesia induction. It’s vital to swallow the capsule whole with water, with or without food.
Dosage adjustment isn’t usually necessary based on age, gender, or renal function. However, for those with moderate to severe hepatic impairment, tailored dosing may be needed, though specific recommendations aren’t provided.
Elderly patients may take Akynzeo without dose adjustments, but caution is advised due to heightened susceptibility to its effects. Akynzeo can be combined with corticosteroids and other antiemetics as prescribed, but caution is urged when coadministered with medications prolonging the QT interval or increasing the risk of serotonin syndrome.
Always follow your healthcare provider’s instructions regarding the dosage and administration of Akynzeo. Do not exceed the recommended dose or alter the dosing schedule without consulting your healthcare provider. If you miss a dose, take it as soon as you remember, but do not take two doses at the same time to make up for a missed dose.
PRESCRIPTION
- Akynzeo is available only with a valid prescription from a healthcare provider.
- It cannot be obtained over-the-counter or without a physician’s authorization.
- Patients must consult with their healthcare provider to assess their condition and determine if Akynzeo is appropriate for their nausea and vomiting management.
- Healthcare providers will evaluate the patient’s medical history, current medications, and potential drug interactions before prescribing Akynzeo.
- Patients should follow their healthcare provider’s instructions regarding dosage, administration, and any precautions or warnings associated with Akynzeo use.
FAQ's
What is Akynzeo used for?
Akynzeo is used to prevent nausea and vomiting caused by chemotherapy, specifically in adults undergoing cancer treatment.
How does Akynzeo work?
Akynzeo works by combining two medications, netupitant and palonosetron, which block signals to the brain that trigger nausea and vomiting.
What is the recommended dosage of Akynzeo?
The typical dosage is one capsule taken orally about one hour before the start of chemotherapy.
Are there any common side effects of Akynzeo?
Common side effects include headache, constipation, fatigue, and indigestion.
Can Akynzeo interact with other medications?
Yes, Akynzeo can interact with certain medications, including some antibiotics, antifungals, and medications that affect the liver enzymes. It’s important to inform your healthcare provider about all medications you are taking.
Is Akynzeo safe for pregnant or breastfeeding women?
The safety of Akynzeo in pregnant or breastfeeding women has not been established. It should be used only if clearly needed and prescribed by a healthcare provider.
How long does Akynzeo last in the body?
The effects of Akynzeo can last for up to five days, providing extended relief from nausea and vomiting.
Can children use Akynzeo?
Akynzeo is not approved for use in pediatric patients and should only be used in adults.
Should Akynzeo be taken with food?
Akynzeo can be taken with or without food. However, following your healthcare provider’s specific instructions is best.
What should I do if I miss a dose of Akynzeo?
If you miss a dose, contact your healthcare provider for further instructions, especially before your chemotherapy session.
How should Akynzeo be stored?
Store Akynzeo at room temperature away from moisture and heat, in its original packaging until it’s time to use it.
Can Akynzeo cause allergic reactions?
Though rare, some individuals may experience allergic reactions to Akynzeo. Symptoms include rash, itching, swelling, dizziness, and trouble breathing. Seek medical attention immediately if these occur.
Is there a generic version of Akynzeo available?
As of now, no generic version of Akynzeo is available. It is only available under its brand name.
What should I avoid while taking Akynzeo?
Avoid consuming alcohol and grapefruit products, as they can increase side effects or interact with the medication.
Can Akynzeo be taken with anti-anxiety medications?
Akynzeo may interact with certain anti-anxiety medications. It’s important to discuss all your current medications with your healthcare provider.
Are there any dietary restrictions while taking Akynzeo?
Generally, no specific dietary restrictions are required, but it’s advisable to follow a balanced diet and avoid known food triggers for nausea.
How is Akynzeo different from other anti-nausea medications?
Akynzeo combines two active ingredients, providing a dual-action approach that targets different pathways in the body to prevent nausea and vomiting.
What happens if I overdose on Akynzeo?
In case of an overdose, seek immediate medical attention. Symptoms may include severe dizziness or fainting.
Can Akynzeo be used for motion sickness?
Akynzeo is specifically formulated for chemotherapy-induced nausea and vomiting and is not indicated for motion sickness.
How soon after taking Akynzeo should I expect it to start working?
Akynzeo typically begins working within one hour, coinciding with the start of chemotherapy to efficiently prevent nausea and vomiting.