What is the difference between the oral and injectable formulations of Akynzeo?

Akynzeo exists in two different dosage forms: either as a combination of palonosetron and netupitant (in the oral formulation) or palonosetron and the prodrug fosnetupitant (in the intravenous formulation).

Palonosetron is a serotonin-3 (5-HT3) receptor antagonist and netupitant/fosnetupitant are substance P/neurokinin-1 (NK-1) receptor antagonists used for prevention of chemotherapy-induced nausea/vomiting (CINV).

Both dosage forms are used in combination with dexamethasone. The oral formulation of Akynzeo is available as 300 mg netupitant/0.5 mg palonosetron and is given as one capsule approximately one hour prior to the start of chemotherapy, with or without food. The injectable formulation of Akynzeo, after reconstitution, is infused over 30 minutes starting 30 minutes prior to chemotherapy.

The IV formulation of Akynzeo is indicated to be used for highly emetogenic chemotherapy, including cisplatin-based chemotherapy.

The oral capsule form of Akynzeo is approved to be used for anthracyclines and cyclophosphamide-based chemotherapy and chemotherapy not considered highly emetogenic. Both products are manufactured by Helsinn Health Care SA.