Uses

Fosaprepitant, a prodrug of aprepitant, is indicated in combination with other antiemetic agents for the prevention of acute and delayed nausea and vomiting associated with highly and moderately emetogenic cancer chemotherapy in adults and pediatric patients 6 months of age and older.

Do not use if

Contraindicated in patients with hypersensitivity to any component, and in patients taking pimozide due to the risk of elevated pimozide plasma concentrations via CYP3A4 inhibition.

Side effects

Common adverse reactions include fatigue, diarrhea, neutropenia, asthenia, anemia, peripheral neuropathy, leukopenia, dyspepsia, and urinary tract infection. Infusion site reactions and hypersensitivity reactions including anaphylaxis have been reported.

Warnings

Fosaprepitant inhibits CYP3A4 and may increase plasma levels of co-administered CYP3A4 substrates; dose adjustments may be required. Monitor for infusion site reactions. Hypersensitivity reactions, including anaphylaxis and anaphylactic shock, have occurred during infusion.

How it works

Fosaprepitant is rapidly converted to aprepitant after intravenous administration. Aprepitant is a selective high-affinity NK1 (neurokinin-1) receptor antagonist that blocks substance P binding in the brain, inhibiting the vomiting reflex at central and peripheral levels.

Storage

Store the lyophilized powder at 2–8°C (36–46°F) refrigerated. The reconstituted solution may be stored at room temperature; follow reconstitution instructions for stability duration.