fosaprepitant + palonosetron

Fosaprepitant + palonosetron is a fixed-dose combination of two antiemetic agents used primarily to prevent nausea and vomiting associated with cancer chemotherapy. Fosaprepitant is an intravenous prodrug of aprepitant, which acts as a neurokinin-1 (NK1) receptor antagonist by blocking the activity of substance P at NK1 receptors in the brain[3]. Palonosetron is a second-generation serotonin 5-HT3 receptor antagonist that prevents emesis by blocking serotonin binding to 5-HT3 receptors located on vagal nerve terminals in the gastrointestinal tract and centrally in the chemoreceptor trigger zone[2][6]. The combination provides synergistic efficacy for both acute and delayed chemotherapy-induced nausea and vomiting (CINV), often administered with dexamethasone for optimal effect[1][7].