Drug interactions
Netupitant-palonosetron + Rasagiline
Severity: Moderate
Netupitant-palonosetron and Rasagiline: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Palonosetron, a 5-HT3 antagonist, has been associated with serotonin syndrome when combined with serotonergic drugs, including MAO inhibitors. Rasagiline adds to serotonergic load, so agitation, autonomic instability, hyperthermia, tremor and neuromuscular hyperactivity are possible. The risk is low-frequency but potentially serious.
What this interaction means in plain words
Netupitant-palonosetron and Rasagiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Netupitant-palonosetron belongs to Gastrointestinal Tract; Rasagiline belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from MAO-B inhibition combined with 5-HT3 receptor antagonism, though the exact mechanism of 5-HT3 antagonist-related serotonin syndrome is not well established.
What to do
Monitor for signs of serotonin syndrome such as mental status change, clonus, hyperthermia and diarrhea when the combination is given, and stop the agents if it develops. Consider another antiemetic if the patient has risk factors for serotonin toxicity.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Netupitant-palonosetron and Rasagiline, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 14 days on the web. No card needed.
Other interactions of Netupitant-palonosetron
- Apomorphine + Netupitant-palonosetron Contraindicated
- Flibanserin + Netupitant-palonosetron Contraindicated
- Apalutamide + Netupitant-palonosetron Major
- Avapritinib + Netupitant-palonosetron Major
- Carbamazepine + Netupitant-palonosetron Major
- Cobimetinib + Netupitant-palonosetron Major
Other interactions of Rasagiline
- Atomoxetine + Rasagiline Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
- Bupropion + Rasagiline Contraindicated
- Clomipramine + Rasagiline Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
Frequently asked questions
Can I take Netupitant-palonosetron with Rasagiline?
MediHelp rates the interaction as moderate. Netupitant-palonosetron and Rasagiline can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Palonosetron, a 5-HT3 antagonist, has been associated with serotonin syndrome when combined with serotonergic drugs, including MAO inhibitors. Rasagiline adds to serotonergic load, so agitation, autonomic instability, hyperthermia, tremor and neuromuscular hyperactivity are possible. The risk is low-frequency but potentially serious.
How serious is the interaction between Netupitant-palonosetron and Rasagiline?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for signs of serotonin syndrome such as mental status change, clonus, hyperthermia and diarrhea when the combination is given, and stop the agents if it develops. Consider another antiemetic if the patient has risk factors for serotonin toxicity.
What other medicines interact with Netupitant-palonosetron?
MediHelp also lists interactions of Netupitant-palonosetron with, for example, Apomorphine, Flibanserin, Apalutamide. The full list is on the Netupitant-palonosetron page.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
