Dimaphen DM and Netupitant and Palonosetron Hydrochloride

• Generic Name: brompheniramine / dextromethorphan / phenylephrine
• Dosage Forms: n.a.
• Other Brand Names: Alahist DM, BP Allergy DM, Bromatan-DM, Children's Cold & Cough DM, Cold & Cough Childrens, Dimaphen DM, Dimetapp Cold & Cough, Dimetapp DM Cold & Cough, DuraTan DM, Rynex DM, TL-Hist DM, Tussi-Pres B, Dimetapp DM Cold/Cough, Glenmax PEB DM FORTE, Glenmax PEB DM, LoHist-DM, Niva-Hist DM, TGQ 75PEH/4BRM/15DM

Brompheniramine is an antihistamine that reduces the effects of the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose.

Dextromethorphan is a cough suppressant. It affects the signals in the brain that trigger cough reflex.

Phenylephrine is a decongestant that shrinks blood vessels in the nasal passages. Dilated blood vessels can cause nasal congestion (stuffy nose).

The combination of brompheniramine, dextromethorphan, and phenylephrine is used to treat runny or stuffy nose, sneezing, itching, watery eyes, cough, and sinus congestion caused by allergies, the common cold, or the flu.

Dimaphen DM will not treat a cough that is caused by smoking, asthma, or emphysema.

Dimaphen DM may also be used for purposes not listed in this medication guide.

• Generic Name: netupitant / palonosetron
• Dosage Forms: n.a.
• Other Brand Names: Akynzeo

Used in fixed combination for prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of cancer chemotherapy, including, but not limited to, highly emetogenic chemotherapy. Should be used in combination with dexamethasone.

Palonosetron prevents nausea and vomiting during the acute phase after chemotherapy; netupitant prevents nausea and vomiting during both the acute and delayed phase after chemotherapy.

For prevention of nausea and vomiting associated with highly emetogenic chemotherapy regimens (including an anthracycline plus cyclophosphamide), ASCO recommends a 3-drug antiemetic regimen consisting of an NK1 receptor antagonist (e.g., either oral aprepitant or IV fosaprepitant), a 5-HT3 receptor antagonist (e.g., dolasetron, granisetron, ondansetron, palonosetron), and dexamethasone. ASCO states that fixed-combination netupitant and palonosetron plus dexamethasone is an additional treatment option.

For moderately emetogenic chemotherapy regimens, ASCO recommends a 2-drug antiemetic regimen preferably consisting of palonosetron and dexamethasone. If palonosetron is not available, a first-generation 5-HT3 receptor antagonist (preferably granisetron or ondansetron) may be substituted. Limited evidence suggests that aprepitant may be added to this regimen; in such cases, use of any 5-HT3 receptor antagonist is appropriate.

For chemotherapy regimens with a low emetogenic risk, ASCO recommends administration of a single dose of dexamethasone prior to chemotherapy.

For chemotherapy regimens with minimal emetogenic risk, ASCO states that routine antiemetic administration is not necessary.