Formulary
Fosaprepitant: Indications, Dosing, Side Effects and Interactions
Fosaprepitant is a prodrug of aprepitant.
MedNext Academy | 3 min read
Fosaprepitant: Indications, Dosing, Side Effects and Interactions
Fosaprepitant is a prodrug of aprepitant.
Drug action
Fosaprepitant is a prodrug of aprepitant.
Indications and dose
**Adjunct to dexamethasone and a 5HT3-receptor antagonist in preventing nausea and vomiting associated with moderately and highly emetogenic chemotherapy**
- **Adult** (By Intravenous Infusion): Adjunct to dexamethasone and a 5HT 3 -receptor antagonist in preventing nausea and vomiting associated with moderately and highly emetogenic chemotherapy 150 mg, dose to be administered over 20-30 minutes and given 30 minutes before chemotherapy on day 1 of cycle only, consult product literature for dose of concomitant corticosteroid and 5HT 3 -receptor antagonist.
**Adjunct to 5HT3-receptor antagonist (with or without dexamethasone) in preventing nausea and vomiting associated with moderately and highly emetogenic chemotherapy for fosaprepitant**
- **Child 6 months-11 years (body-weight 6 kg and above)** (By intravenous infusion): Initially 3 mg/kg (max. per dose 115 mg) on day 1 of cycle, then 2 mg/kg (max. per dose 80 mg) on days 2 and 3 of cycle, dose to be administered over 60 minutes and completed 30 minutes before chemotherapy, consult product literature for dose of concomitant corticosteroid and 5HT3-receptor antagonist and for information on alternative dosing for single and multi-day regimens.
- **Child 12-17 years** (By intravenous infusion): Initially 115 mg on day 1 of cycle, then 80 mg on days 2 and 3 of cycle, dose to be administered over 30 minutes and completed 30 minutes before chemotherapy, consult product literature for dose of concomitant corticosteroid and 5HT3-receptor antagonist and for information on alternative dosing for single and multi-day regimens.
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; flushing; gastrointestinal disorders; malaise; nausea; palpitations; skin reactions; thrombophlebitis; 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
**Other interactions (1):**
- Antiemetics - Aprepitant and fosaprepitant (CYP3A4 inhibitors and substrates).
Pregnancy
Avoid unless potential benefit outweighs risk-no information available.
Breast feeding
Avoid-present in milk in animal studies.
Hepatic impairment
Manufacturer advises caution in moderate to severe impairment-limited information available.
Medicinal forms
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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