Product Details
Akynzeo
Netupitant + Palonosetron Hydrochloride300 mg + 0.5 mg
Capsule
DIN/PIN/NPN
02468735
Manufacturer
Knight Therapeutics Inc.
Formulary Listing Date
2019-06-28
Unit Price
144.0075
Amount MOH Pays
144.0075
Coverage Status
Limited Use Product
ODB Formulary Therapeutic Classification
Therapeutic Note
NO
ATC Code
A04AA55
Interchangeable Products
NOLU Clinical Criteria
| LU Code | Auth. Period | Clinical Criteria |
|---|---|---|
| 561 | 1 year | In combination with dexamethasone for once per-cycle treatment in adult patients for: - Prevention of acute and delayed nausea and vomiting associated with highly emetogenic cancer chemotherapy (HEC). Highly emetogenic chemotherapy (HEC) regimens: - Cisplatin-based chemotherapy where a single daily dose is greater than or equal to 70mg per meter squared - Cisplatin and cyclophosphamide combinations where the single daily dose of cisplatin is greater than or equal to 50mg per meter squared - Non-cisplatin based highly emetogenic chemotherapy (such as those containing anthracycline greater than or equal to 60mg per meter squared plus cyclophosphamide). Dosage: Recommend Netupitant/Palonosetron 300mg/0.5mg orally on Day 1 approximately 1 hour prior to the start of each HEC. |
| 562 | 1 year | In combination with dexamethasone for once per-cycle treatment in adult patients for: - Prevention of acute nausea and vomiting associated with moderately emetogenic cancer therapy (MEC) that is uncontrolled by a 5-hydroxytryptamine-3 (5-HT3) receptor antagonist (RA) alone in a previous cycle. Dosage: Recommend Netupitant/Palonosetron 300mg/0.5mg orally on Day 1 approximately 1 hour prior to the start of each MEC cycle. |