Drug interactions
Netupitant-palonosetron + Tucatinib
Severity: Moderate
Netupitant-palonosetron and Tucatinib: 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
Tucatinib inhibits CYP3A4 and can raise plasma levels of CYP3A substrates such as netupitant. Higher netupitant exposure may increase adverse effects including headache, constipation and fatigue. Palonosetron is cleared by several pathways, so the effect is mainly via netupitant.
What this interaction means in plain words
Netupitant-palonosetron and Tucatinib 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; Tucatinib belongs to Oncology.
Why it happens
Tucatinib inhibits CYP3A4, reducing the metabolism of netupitant.
What to do
Monitor for increased netupitant adverse effects when given together with tucatinib; a single antiemetic dose cycle is usually tolerable. Consider an alternative antiemetic regimen in patients with significant hepatic impairment or poor tolerance.
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?
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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 Tucatinib
- Cisapride + Tucatinib Contraindicated
- Eletriptan + Tucatinib Contraindicated
- Ergotamine + Tucatinib Contraindicated
- Flibanserin + Tucatinib Contraindicated
- Ranolazine + Tucatinib Contraindicated
- Amobarbital + Tucatinib Major
Frequently asked questions
Can I take Netupitant-palonosetron with Tucatinib?
MediHelp rates the interaction as moderate. Netupitant-palonosetron and Tucatinib 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. Tucatinib inhibits CYP3A4 and can raise plasma levels of CYP3A substrates such as netupitant. Higher netupitant exposure may increase adverse effects including headache, constipation and fatigue. Palonosetron is cleared by several pathways, so the effect is mainly via netupitant.
How serious is the interaction between Netupitant-palonosetron and Tucatinib?
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 increased netupitant adverse effects when given together with tucatinib; a single antiemetic dose cycle is usually tolerable. Consider an alternative antiemetic regimen in patients with significant hepatic impairment or poor tolerance.
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.
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