Akynzeo Dosage

Generic name: NETUPITANT 300mg, PALONOSETRON 0.5mg
Dosage form: capsules, injection
Drug class: Miscellaneous antiemetics

Medically reviewed by Drugs.com. Last updated on Dec 10, 2023.

Recommended Dosage

The recommended dosages of AKYNZEO and dexamethasone in adults for the prevention of nausea and vomiting associated with administration of emetogenic chemotherapy are shown in Table 1.

AKYNZEO capsules can be taken with or without food.

Table 1: Antiemetic Treatment Regimen
Treatment Regimen	Day 1		Days 2 to 4
Highly Emetogenic Chemotherapy, including Cisplatin-Based Chemotherapy
AKYNZEO capsules	1 capsule of AKYNZEO	1 hour before chemotherapy	Dexamethasone 8 mg once a day
	Dexamethasone 12 mg	30 minutes before chemotherapy
AKYNZEO for injection and AKYNZEO injection	1 vial of AKYNZEO	Infuse over 30 minutes starting 30 minutes before chemotherapy [see Dosage and Administration (2.2)]	Dexamethasone 8 mg once a day
	Dexamethasone 12 mg	30 minutes before chemotherapy
Anthracyclines and Cyclophosphamide-Based Chemotherapy and Chemotherapy Not Considered Highly Emetogenic
AKYNZEO capsules	1 capsule of AKYNZEO	1 hour before chemotherapy	None
	Dexamethasone 12 mg	30 minutes before chemotherapy

Preparation and Administration of AKYNZEO Injection (Ready-to-Use and To-be-Diluted)

AKYNZEO injection is supplied as either a Ready-to-Use (with hanger) vial or a To-be-Diluted vial.

AKYNZEO injection (Ready-to-Use; with hanger)
See Table 2 for preparation instructions of AKYNZEO injection (Ready-to-Use) for intravenous infusion. AKYNZEO injection (Ready-to-Use) does not require dilution prior to administration.

Table 2: Preparation and Administration of AKYNZEO Injection (Ready-to-Use) for Intravenous Infusion
Step 1	Before administration, inspect the solution for particulate matter and discoloration. Discard the vial if particulates and/or discoloration are observed.
Step 2	Using aseptic technique, insert a vented intravenous set through the septum of the vial. Once the stopper is punctured, use immediately.
Step 3	To administer, invert and hang the vial utilizing the strap affixed to the bottom of the vial.
Step 4	Administer over 30 minutes as an intravenous infusion. At the end of the infusion, flush the infusion line with 0.9% Sodium Chloride Injection, USP or with 5% Dextrose injection, USP to ensure complete drug administration.

AKYNZEO injection (Ready-to-Use) contains no antimicrobial preservatives and is intended for single use only.

Compatibility
AKYNZEO injection (Ready-to-Use) is compatible with intravenous dexamethasone sodium phosphate which can be infused simultaneously. Do not add dexamethasone sodium phosphate to the AKYNZEO injection (Ready-to-Use) vial.

Stability and Storage
Use immediately once the stopper is punctured.

AKYNZEO Injection (To-be-Diluted)
See Table 3 for preparation instructions of AKYNZEO injection (To-be-Diluted) for intravenous infusion with dilution.

Table 3: Preparation and Administration of AKYNZEO Injection (To-be-Diluted) for Intravenous Infusion
Step 1	Before administration, inspect the solution for particulate matter and discoloration. Discard the vial if particulates and/or discoloration are observed.
Step 2	Aseptically prepare an infusion vial or bag filled with 30 mL of 5% Dextrose injection, USP or 0.9% Sodium Chloride injection, USP.
Step 3	Aseptically withdraw the entire volume of solution from the AKYNZEO vial (20 mL) and transfer it into the infusion vial or bag containing 30 mL of 5% Dextrose injection, USP or 0.9% Sodium Chloride injection, USP to yield a total volume of 50 mL.
Step 4	Gently invert the vial or bag until complete dissolution.
Step 5	Before administration, inspect the final diluted solution for particulate matter and discoloration. Discard the vial or bag if particulates and/or discoloration are observed.
Step 6	Administer over 30 minutes as an intravenous infusion. At the end of the infusion, flush the infusion line with the same carrier solution to ensure complete drug administration.

AKYNZEO injection (To-be-Diluted) contains no antimicrobial preservatives and is intended for single use only.

Compatibility

AKYNZEO injection (To-be-Diluted) is compatible with intravenous dexamethasone sodium phosphate which can be added to the infusion bag containing AKYNZEO solution or infused simultaneously.

Stability and Storage

The total time from dilution to the start of the infusion, with or without intravenous dexamethasone sodium phosphate, should not exceed 24 hours.

Store the final diluted solution at room temperature, 20ºC to 25ºC (68Fº to 77ºF).

Preparation and Administration of AKYNZEO for Injection

See Table 4 for preparation instructions of AKYZNEO for injection. AKYNZEO for injection requires dilution prior to administration.

Table 4: Preparation and Administration of AKYNZEO for Injection
Step 1	Aseptically inject 20 mL 5% Dextrose injection, USP or 0.9% Sodium Chloride injection, USP into the vial. Ensure the solvent is added to the vial along the vial wall and not jetted in order to prevent foaming. Swirl the vial gently.
Step 2	Aseptically prepare an infusion vial or bag filled with 30 mL of 5% Dextrose injection, USP or 0.9% Sodium Chloride injection, USP.
Step 3	Aseptically withdraw the entire volume of solution from the AKYNZEO vial and transfer it into the infusion vial or bag containing 30 mL of 5% Dextrose injection, USP or 0.9% Sodium Chloride injection, USP to yield a total volume of 50 mL.
Step 4	Gently invert the vial or bag until complete dissolution.
Step 5	Before administration, inspect the final diluted solution for particulate matter and discoloration. Discard the vial or bag if particulates and/or discoloration are observed.
Step 6	Administer over 30 minutes as an intravenous infusion. At the end of the infusion, flush the infusion line with the same carrier solution to ensure complete drug administration.

AKYNZEO for injection contains no antimicrobial preservatives, is intended for single use only.

Compatibility

AKYNZEO for injection is compatible with intravenous dexamethasone sodium phosphate which can be added to the infusion bag containing AKYNZEO solution or infused simultaneously.

Stability and Storage

The total time from reconstitution to the start of the infusion, with or without intravenous dexamethasone sodium phosphate, should not exceed 24 hours.

Store the reconstituted solution and the final diluted solution at room temperature, 20ºC to 25ºC (68ºF to 77ºF).

Incompatibility of AKYNZEO for Injection and AKYZNEO Injection

AKYNZEO for injection, AKYNZEO injection (Ready-to-Use) and AKYNZEO injection (To-be-Diluted) are incompatible with any solution containing divalent cations (e.g., calcium, magnesium), including Lactated Ringer’s injection and Hartmann's Solution.

Limited data are available on the compatibility of AKYNZEO for injection, AKYNZEO injection (Ready-to-Use), and AKYNZEO injection (To-be-Diluted) with other intravenous substances, additives, or other medications with the exception of intravenous dexamethasone sodium phosphate [see Dosage and Administration (2.2, 2.3)] and they should not be added to the AKYNZEO solution or infused simultaneously. If the same intravenous line is used for sequential infusion of several different drugs, flush the line before and after infusion of AKYNZEO solution with 0.9% Sodium Chloride Injection, USP.