aprepitant at a glance
Medicine class
Neurokinin-1 receptor antagonist antiemetic
Usual role
Prevention of nausea and vomiting from moderately or highly emetogenic cancer chemotherapy
Combination treatment
Used with other anti-sickness treatments rather than alone
Food
Capsules and oral suspension may be taken with or without food
What is aprepitant used for?
Selected licensed uses include:
Prevention of chemotherapy-induced nausea and vomiting in adults and adolescents receiving moderately or highly emetogenic chemotherapy, using capsules as part of combination treatment.
Prevention of chemotherapy-induced nausea and vomiting in children aged 6 months to under 12 years and weighing at least 6 kg, using oral suspension as part of combination treatment.
Paediatric specialists may also use aprepitant for nausea and vomiting associated with headaches. It is not licensed for every underlying condition.
How does aprepitant work?
Aprepitant blocks neurokinin-1 receptors, preventing substance P from activating vomiting pathways in the brain. This helps control early and delayed chemotherapy-related nausea and vomiting.
aprepitant preparations and strengths
Capsule
Route: Oral
Strengths: 80 mg, 125 mg, 125 mg + 80 mg
How to take aprepitant
Follow the oncology team's written instructions, because aprepitant is coordinated with chemotherapy and other anti-sickness treatments.
Swallow hard capsules whole; they may be taken with or without food.
The selected oral suspension must be prepared and measured by a healthcare professional.
Give a supplied pre-filled oral dispenser slowly into the inside of the child's cheek. Contact the healthcare team if the full amount cannot be taken.
Keep prepared oral suspension as directed on its label.
aprepitant side effects
Common or expected effects
- Hiccups
- Headache
- Constipation or indigestion
- Reduced appetite
- Tiredness
- Raised liver enzymes on blood tests
Get urgent medical advice
- Severe allergic reaction, including breathing or swallowing difficulty, hives or swelling
- Severe blistering or peeling skin reaction, including Stevens–Johnson syndrome or toxic epidermal necrolysis
aprepitant in pregnancy
Human pregnancy data are lacking, so aprepitant should be used during pregnancy only when the prescriber considers it clearly necessary. Discuss pregnancy, plans to conceive and contraception with the oncology team before treatment; aprepitant can reduce hormonal contraceptive effectiveness.
aprepitant while breastfeeding
It is unknown whether aprepitant enters human milk, and the selected product information does not recommend breastfeeding during treatment. If treatment is essential, the oncology team should assess the medicine, the infant and the benefits of breastfeeding.
aprepitant interactions
Aprepitant both affects and is affected by liver enzymes, so the complete prescription, non-prescription and herbal medicine list should be checked.
Pimozide, terfenadine, astemizole or cisapride
Co-administration is contraindicated because aprepitant may greatly increase concentrations and cause serious reactions.
Dexamethasone or methylprednisolone
Aprepitant increases corticosteroid exposure, so the oncology regimen must account for the interaction.
Warfarin
The anticoagulant effect may change after aprepitant; INR requires close monitoring during and after treatment.
Common questions about aprepitant
Answers are fully visible for fast scanning and source review.
What is aprepitant used for?
It is used with other anti-sickness treatments to prevent nausea and vomiting caused by moderately or highly emetogenic cancer chemotherapy.
Does aprepitant treat sickness after it starts?
Its selected licences are for prevention rather than rescue treatment. Contact the oncology team if nausea or vomiting occurs despite the planned medicines.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.