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Details

Stereochemistry ACHIRAL
Molecular Formula C31H35F6N4O5P
Molecular Weight 688.5976
Optical Activity NONE
Defined Stereocenters 0 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of FOSNETUPITANT

SMILES

CN(C(=O)C(C)(C)C1=CC(=CC(=C1)C(F)(F)F)C(F)(F)F)C2=C(C=C(N=C2)N3CC[N+](C)(COP(O)([O-])=O)CC3)C4=C(C)C=CC=C4

InChI

InChIKey=HZIYEEMJNBKMJH-UHFFFAOYSA-N
InChI=1S/C31H35F6N4O5P/c1-20-8-6-7-9-24(20)25-17-27(40-10-12-41(5,13-11-40)19-46-47(43,44)45)38-18-26(25)39(4)28(42)29(2,3)21-14-22(30(32,33)34)16-23(15-21)31(35,36)37/h6-9,14-18H,10-13,19H2,1-5H3,(H-,43,44,45)

HIDE SMILES / InChI

Molecular Formula C31H35F6N4O5P
Molecular Weight 688.5976
Charge 0
Count
Stereochemistry RACEMIC
Additional Stereochemistry No
Defined Stereocenters 0 / 1
E/Z Centers 0
Optical Activity NONE

Description
Curator's Comment: description was created based on several sources, including http://www.ncbi.nlm.nih.gov/pubmed/?term=16332435; http://www.ncbi.nlm.nih.gov/pubmed/?term=24631949

Fosnetupitant is a prodrug form of netupitant. Netupitant is a selective antagonist of human substance P/neurokinin 1 (NK-1) receptors. Upon intravenous administration, fosnetupitant is converted by phosphatases to its active form. It competitively binds to and blocks the activity of NK-1 receptors in the central nervous system, by inhibiting binding of substance P (SP) to NK-1 receptors. This prevents delayed emesis, which is associated with SP secretion. AKYNZEO® is a combination of palonosetron, a serotonin-3 receptor antagonist, and netupitant (capsules for oral use) or fosnetupitant (injections for intravenous use). AKYNZEO® for injection is indicated in combination with dexamethasone in adults for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy.

CNS Activity

Curator's Comment: Studies in rodents suggest that Netupitant behaves as a brain penetrant, orally active

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
0.95 nM [Ki]
Target ID: P25103
Gene ID: 6869.0
Gene Symbol: TACR1
Target Organism: Homo sapiens (Human)
0.95 nM [Ki]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Primary
AKYNZEO

Approved Use

AKYNZEO for injection is indicated in combination with dexamethasone in adults for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy.

Launch Date

2018
Preventing
Akynzeo

Approved Use

To treat nausea and vomiting in patients undergoing cancer chemotherapy

Launch Date

2014
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
434 ng/mL
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NETUPITANT plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
14401 ng × h/mL
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NETUPITANT plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
96 h
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NETUPITANT plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Funbound

Funbound

ValueDoseCo-administeredAnalytePopulation
0.5%
300 mg single, oral
dose: 300 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
NETUPITANT plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: UNKNOWN
food status: UNKNOWN
Doses

Doses

DosePopulationAdverse events​
600 mg 1 times / day single, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: single
Dose: 600 mg, 1 times / day
Sources:
healthy, mean age 32.8 years
Other AEs: Palpitations, Constipation...
Other AEs:
Palpitations (2%)
Constipation (4.1%)
Pain in extremity (2%)
Dizziness (2%)
Headache (10.2%)
Somnolence (2%)
Anxiety (2%)
Euphoric mood (2%)
Sources:
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Disc. AE: Neutropenia, Neoplasm progression...
AEs leading to
discontinuation/dose reduction:
Neutropenia (0.5%)
Neoplasm progression (0.5%)
Neoplasm malignant (0.4%)
Febrile neutropenia (0.2%)
Leukopenia (0.2%)
Thrombocytopenia (0.1%)
Peritonitis (0.1%)
Troponin increased (0.1%)
Stomatitis (0.2%)
ALT increased (0.2%)
Platelet count decreased (0.2%)
Angina pectoris (0.1%)
Myocardial ischaemia (0.1%)
Creatinine renal clearance decreased (0.1%)
Sources:
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Other AEs: Febrile neutropenia, Neutropenia...
Other AEs:
Febrile neutropenia (1.5%)
Neutropenia (1%)
Vomiting (0.6%)
Anaemia (0.5%)
Leukopenia (0.3%)
Pneumonia (0.4%)
Urinary tract infection (0.3%)
Pulmonary embolism (0.2%)
Cardiopulmonary failure (0.3%)
Stomatitis (0.3%)
Asthenia (0.2%)
Neoplasm malignant (0.2%)
Nausea (0.1%)
Peritonitis (0.1%)
Renal failure (0.1%)
Abdominal pain (0.2%)
Diarrhoea (0.2%)
Multi-organ failure (0.2%)
Pyrexia (0.2%)
Femur fracture (0.2%)
Neoplasm progression (0.2%)
Metrorrhagia (0.2%)
Haemoptysis (0.2%)
Thrombocytopenia (0.1%)
Electrolyte imbalance (0.1%)
Convulsion (0.1%)
Deep vein thrombosis (0.1%)
Sources:
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Other AEs: ALT increased, AST increased...
Other AEs:
ALT increased (grade 3, 1.3%)
AST increased (grade 3, 0.8%)
AST increased (grade 4, 0.1%)
Alkaline phosphatase increased (grade 3, 0.4%)
Hyperglycemia (grade 3, 7.8%)
Hyperglycemia (grade 4, 0.6%)
Hypokalemia (grade 3, 1.4%)
Hypokalemia (grade 4, 0.4%)
Hyponatremia (grade 3, 4.9%)
Hyponatremia (grade 4, 0.6%)
Sources:
AEs

AEs

AESignificanceDosePopulation
Headache 10.2%
600 mg 1 times / day single, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: single
Dose: 600 mg, 1 times / day
Sources:
healthy, mean age 32.8 years
Anxiety 2%
600 mg 1 times / day single, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: single
Dose: 600 mg, 1 times / day
Sources:
healthy, mean age 32.8 years
Dizziness 2%
600 mg 1 times / day single, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: single
Dose: 600 mg, 1 times / day
Sources:
healthy, mean age 32.8 years
Euphoric mood 2%
600 mg 1 times / day single, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: single
Dose: 600 mg, 1 times / day
Sources:
healthy, mean age 32.8 years
Pain in extremity 2%
600 mg 1 times / day single, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: single
Dose: 600 mg, 1 times / day
Sources:
healthy, mean age 32.8 years
Palpitations 2%
600 mg 1 times / day single, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: single
Dose: 600 mg, 1 times / day
Sources:
healthy, mean age 32.8 years
Somnolence 2%
600 mg 1 times / day single, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: single
Dose: 600 mg, 1 times / day
Sources:
healthy, mean age 32.8 years
Constipation 4.1%
600 mg 1 times / day single, oral
Highest studied dose
Dose: 600 mg, 1 times / day
Route: oral
Route: single
Dose: 600 mg, 1 times / day
Sources:
healthy, mean age 32.8 years
Angina pectoris 0.1%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Creatinine renal clearance decreased 0.1%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Myocardial ischaemia 0.1%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Peritonitis 0.1%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Thrombocytopenia 0.1%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Troponin increased 0.1%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
ALT increased 0.2%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Febrile neutropenia 0.2%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Leukopenia 0.2%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Platelet count decreased 0.2%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Stomatitis 0.2%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Neoplasm malignant 0.4%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Neoplasm progression 0.5%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Neutropenia 0.5%
Disc. AE
300 mg 1 times / 5 weeks multiple, oral
Recommended
unhealthy, median age 55 years
Convulsion 0.1%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Deep vein thrombosis 0.1%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Electrolyte imbalance 0.1%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Nausea 0.1%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Peritonitis 0.1%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Renal failure 0.1%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Thrombocytopenia 0.1%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Abdominal pain 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Asthenia 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Diarrhoea 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Femur fracture 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Haemoptysis 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Metrorrhagia 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Multi-organ failure 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Neoplasm malignant 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Neoplasm progression 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Pulmonary embolism 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Pyrexia 0.2%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Cardiopulmonary failure 0.3%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Leukopenia 0.3%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Stomatitis 0.3%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Urinary tract infection 0.3%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Pneumonia 0.4%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Anaemia 0.5%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Vomiting 0.6%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Neutropenia 1%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Febrile neutropenia 1.5%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Alkaline phosphatase increased grade 3, 0.4%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
AST increased grade 3, 0.8%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
ALT increased grade 3, 1.3%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Hypokalemia grade 3, 1.4%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Hyponatremia grade 3, 4.9%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Hyperglycemia grade 3, 7.8%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
AST increased grade 4, 0.1%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Hypokalemia grade 4, 0.4%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Hyperglycemia grade 4, 0.6%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
Hyponatremia grade 4, 0.6%
300 mg 1 times / 5 weeks multiple, oral
Recommended
Dose: 300 mg, 1 times / 5 weeks
Route: oral
Route: multiple
Dose: 300 mg, 1 times / 5 weeks
Sources:
unhealthy, median age 55 years
Health Status: unhealthy
Age Group: median age 55 years
Sex: M+F
Sources:
OverviewDrug as perpetrator​

Drug as perpetrator​

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
weak [IC50 22.6 uM]
weak [IC50 23.73 uM]
weak [IC50 26.41 uM]
weak [IC50 33.26 uM]
weak [IC50 38.84 uM]
weak [IC50 39.04 uM]
weak [IC50 39.39 uM]
weak [IC50 57.45 uM]
weak [IC50 6 uM]
weak [IC50 8.6 uM]
weak
weak
yes [IC50 1.2 uM]
yes [IC50 19 uM]
yes [IC50 22.3 uM]
yes [IC50 22.6 uM]
yes [IC50 33.38 uM]
yes [IC50 4.74 uM]
yes [IC50 4.89 uM]
yes [IC50 4.95 uM]
yes [IC50 50.4 uM]
yes [IC50 7.4 uM]
yes [IC50 7.9 uM]
yes [IC50 8 uM]
yes [IC50 8.54 uM]
yes [Ki 1.1 uM]
yes
Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
no
yes
yes
yes
yes
yes
yes (co-administration study)
Comment: Administration of the CYP3A4 inhibitor ketoconazole with netupitant/palonosetron FDC increased the exposure of netupitant and resulted in an AUC0-tz of 1.8 fold, AUC0-’ of 2.4 fold, and Cmax of 1.3 fold when compared to the administration of netupitant/palonosetron FDC alone.
Page: 73.0
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Phase III safety study of intravenous NEPA: a novel fixed antiemetic combination of fosnetupitant and palonosetron in patients receiving highly emetogenic chemotherapy.
2018-07-01
Differential and additive suppressive effects of 5-HT3 (palonosetron)- and NK1 (netupitant)-receptor antagonists on cisplatin-induced vomiting and ERK1/2, PKA and PKC activation.
2015-04
A phase III study evaluating the safety and efficacy of NEPA, a fixed-dose combination of netupitant and palonosetron, for prevention of chemotherapy-induced nausea and vomiting over repeated cycles of chemotherapy.
2014-07
Novel neurokinin-1 antagonists as antiemetics for the treatment of chemotherapy-induced emesis.
2006-04-01
Efficient synthesis of novel NK1 receptor antagonists: selective 1,4-addition of grignard reagents to 6-chloronicotinic acid derivatives.
2006-03-03
Design and synthesis of a novel, achiral class of highly potent and selective, orally active neurokinin-1 receptor antagonists.
2006-03-01
Patents

Sample Use Guides

One AKYNZEO (netupitant and palonosetron) capsule administered approximately 1 hour prior to the start of chemotherapy with dexamethasone 12 mg administered orally 30 minutes prior to chemotherapy on day 1 and 8 mg orally once daily on days 2 to 4 (for highly emetogenic chemotherapy, including cisplatin based chemotherapy) or on day 1 with not necessary administration of dexamethasone on days 2 to 4 (for anthracyclines and cyclophosphamide based chemotherapy and chemotherapy not considered highly emetogenic)
Route of Administration: Oral
In Vitro Use Guide
HEK-293 cells were incubated with 5 nM [3H]-netupitant for 40 min at room temperature.
Substance Class Chemical
Created
by admin
on Mon Mar 31 23:43:10 GMT 2025
Edited
by admin
on Mon Mar 31 23:43:10 GMT 2025
Record UNII
T672P80L2S
Record Status Validated (UNII)
Record Version
  • Download
Name Type Language
fosnetupitant [INN]
Preferred Name English
FOSNETUPITANT
INN   USAN   WHO-DD  
USAN   INN  
Official Name English
Fosnetupitant [WHO-DD]
Common Name English
07-PNET
Code English
FOSNETUPITANT [USAN]
Common Name English
PIPERAZINIUM, 4-(5-((2-(3,5-BIS(TRIFLUOROMETHYL)PHENYL)-2-METHYL-1-OXOPROPYL)METHYLAMINO)-4-(2-METHYLPHENYL)-2-PYRIDINYL)-1-METHYL-1-((PHOSPHONOOXY)METHYL)-
Systematic Name English
PIPERAZINIUM, 4-(5-((2-(3,5-BIS(TRIFLUOROMETHYL)PHENYL)-2-METHYL-1-OXOPROPYL)METHYLAMINO)-4-(2-METHYLPHENYL)-2-PYRIDINYL)-1-METHYL-1-((PHOSPHONOOXY)METHYL)-, INNER SALT
Systematic Name English
Code System Code Type Description
DRUG CENTRAL
5283
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
NCI_THESAURUS
C170011
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
CAS
1703748-89-3
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
INN
10146
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
EPA CompTox
DTXSID601027641
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
DRUG BANK
DB14019
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
RXCUI
2044417
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
SMS_ID
100000176234
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
PUBCHEM
71544786
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
FDA UNII
T672P80L2S
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
DAILYMED
T672P80L2S
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
CAS
1431216-59-9
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
ALTERNATIVE
USAN
EF-24
Created by admin on Mon Mar 31 23:43:10 GMT 2025 , Edited by admin on Mon Mar 31 23:43:10 GMT 2025
PRIMARY
Related Record Type Details
SALT/SOLVATE -> PARENT
Related Record Type Details
METABOLITE ACTIVE -> PRODRUG
Related Record Type Details
ACTIVE MOIETY
Name Property Type Amount Referenced Substance Defining Parameters References
Biological Half-life PHARMACOKINETIC INJECTION ADMINISTRATION

Tmax PHARMACOKINETIC INJECTION ADMINISTRATION