There are no contraindications to treatment with netupitant/palonosetron.
Hypersensitivity reactions, including anaphylaxis, have been reported in patients receiving palonosetron with or without known hypersensitivity to other 5-HT3 receptor antagonists.
Serotonin syndrome has been reported with 5-HT3 receptor antagonists alone, but particularly with concomitant use of serotonergic drugs. Symptoms associated with serotonin syndrome may include the following combination of signs and symptoms: mental status changes, autonomic instability, neuromuscular symptoms, seizures, and gastrointestinal symptoms. Patients should be monitored for the emergence of serotonin syndrome, especially with concomitant use of netupitant/palonosetron and other serotonergic drugs.