Formulary
Aprepitant: Indications, Dosing, Side Effects and Interactions
Aprepitant clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Aprepitant: Indications, Dosing, Side Effects and Interactions
Aprepitant clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Adjunct treatment to prevent nausea and vomiting associated with moderately and highly emetogenic chemotherapy**
- **Adult** (By Mouth): Initially 125 mg, dose to be taken 1 hour before chemotherapy, then 80 mg once daily for 2 days, consult product literature for dose of concomitant dexamethasone and 5HT 3 -antagonist.
**Adjunct treatment to prevent nausea and vomiting associated with moderately and highly emetogenic chemotherapy for aprepitant**
- **Child 6 months-11 years (body-weight 6 kg and above)** (By mouth): (consult product literature).
- **Child 12-17 years** (By mouth): Initially 125 mg, dose to be taken 1 hour before chemotherapy, then 80 mg once daily for 2 days, dose to be taken 1 hour before chemotherapy or in the morning if no chemotherapy is given, consult product literature for dose of concomitant 5HT3-antagonist (and corticosteroid if required).
Contraindications
Acute porphyrias
Side effects
Common or very common Appetite decreased; asthenia; constipation; gastrointestinal discomfort; headache; hiccups Uncommon Anaemia; anxiety; burping; dizziness; drowsiness; dry mouth; febrile neutropenia; gastrointestinal disorders; hot flush; malaise; nausea; palpitations; skin reactions; urinary disorders; vomiting Rare or very rare Bradycardia; cardiovascular disorder; chest discomfort; cognitive disorder; conjunctivitis; cough; disorientation; euphoric mood; gait abnormal; hyperhidrosis; increased risk of infection; muscle spasms; muscle weakness; oedema; oropharyngeal pain; photosensitivity reaction; polydipsia; seborrhoea; severe cutaneous adverse reactions (SCARs); sneezing; stomatitis; taste altered; throat irritation; tinnitus; weight decreased Frequency not known Dysarthria; dyspnoea; insomnia; miosis; sensation abnormal; visual acuity decreased; wheezing
Interactions
**Severe interactions:**
- Inhibition of CYP3A4 by aprepitant could result in elevated plasma concentrations of these active substances, potentially causing serious or life-threatening reactions.
- The effect is maintained for a few days, thereafter slowly declines and is clinically insignificant by two weeks after end of aprepitant treatment.
**Other interactions (46):**
- Aprepitant (125 mg/80 mg) is a substrate, a moderate inhibitor, and an inducer of CYP3A4.
- Aprepitant is also an inducer of CYP2C9.
- During treatment with aprepitant CYP3A4 is inhibited.
- After the end of treatment, aprepitant causes a transient mild induction of CYP2C9, CYP3A4 and glucuronidation.
- Aprepitant does not seem to interact with the P-glycoprotein transporter, as suggested by the lack of interaction of aprepitant with digoxin.
- Effect aprepitant on the pharmacokinetics of other active substances CYP3A4 inhibition As a moderate inhibitor of CYP3A4, aprepitant (125 mg/80 mg) can increase plasma concentrations of...
Pregnancy
Manufacturer advises avoid unless clearly necessary-no information available.
Breast feeding
Manufacturer advises avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises caution in moderate to severe impairment-limited information available.
Medicinal forms
Suspension
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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