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At a glance

Aprepitant is an antiemetic medication used to prevent nausea and vomiting caused by chemotherapy and postoperative nausea and vomiting in adults.

Indications
  • Prevention of chemotherapy-induced nausea and vomiting (CINV)
  • Prevention of postoperative nausea and vomiting (PONV)
Pharmacology

Aprepitant is a selective high affinity antagonist of human substance P neurokinin 1 (NK1) receptors. When substance P attaches to these receptors, it causes nausea and vomiting. Aprepitant stops substance P from binding to the NK1 receptors.

Aprepitant also enhances the antiemetic activity of 5HT3 antagonists and corticosteroids.

Dosage

Postoperative Nausea and Vomiting (PONV):

  • 40 mg orally within 3 hours prior to induction of anesthesia

Chemotherapy-Induced Nausea and Vomiting (CINV):

Highly Emetogenic Chemotherapy:

DayAprepitantDexamethasone5HT3 Antagonist
Day 1125 mg (1 hr before chemo)12 mg (30 min before chemo)Ondansetron 24 mg (30 min before chemo)
Day 280 mg (morning)8 mg (morning)—
Day 380 mg (morning)8 mg (morning)—
Day 4—8 mg (morning)—

Moderately Emetogenic Chemotherapy:

DayAprepitantDexamethasone5HT3 Antagonist
Day 1125 mg (1 hr before chemo)12 mg (30 min before chemo)Ondansetron 8 mg (30 min before chemo) + 8 mg (8 hr later)
Day 280 mg (morning)—Ondansetron 8 mg twice daily
Day 380 mg (morning)—Ondansetron 8 mg twice daily

Special Populations: No dose adjustment needed in renal impairment. No dose adjustment needed in mild-moderate hepatic impairment. No dose adjustment needed in elderly patients.

Side effects
  • Headache
  • Dizziness
  • Hiccup
  • Loss of appetite
  • Fatigue
  • Constipation
  • Hypotension
  • Pruritus
  • Pyrexia
Use in pregnancy

[CONSULT YOUR DOCTOR] Aprepitant may be unsafe to use during pregnancy (Pregnancy Category B). Animal studies have shown harmful effects on the developing baby. Your doctor will weigh the benefits and potential risks before prescribing. Use only if clearly needed.

Pregnancy Category: B — always consult a doctor before taking during pregnancy.

Precautions & warnings

Serious Precautions:

  • Will not help if you already have nausea and vomiting
  • Do not use continuously for a long time
  • May damage sperms and may harm the baby if used during pregnancy or breastfeeding
  • May cause dizziness and sleepiness - do not drive if affected
  • May cause diarrhea - drink plenty of fluids
  • Consult your doctor if pregnant, planning pregnancy or breastfeeding
  • Inform your doctor if you have kidney or liver diseases
Overdose effects

Single doses up to 600 mg of aprepitant were generally well tolerated. Overdose may cause drowsiness and headache. In the event of overdose, discontinue aprepitant and provide general supportive treatment. Aprepitant cannot be removed by hemodialysis.

Storage conditions

Store below 30°C, away from light & moisture. Keep out of reach of children.

Aprepitant — see the full informationPharmacology, precautions, pregnancy, overdose and the rest on the generic page
⚠️ This information is for educational purposes only — not a substitute for medical advice. Consult a registered physician before taking any medicine.