fosaprepitant dimeglumine at a glance
Medicine class
Neurokinin-1 receptor antagonist prodrug
Licensed role
Prevention of nausea and vomiting with highly or moderately emetogenic cancer chemotherapy
Administration
Diluted intravenous infusion given by a healthcare professional
Combination treatment
Used with other anti-sickness treatments
What is fosaprepitant dimeglumine used for?
It is licensed as part of combination treatment to prevent chemotherapy-induced nausea and vomiting.
Prevention of nausea and vomiting associated with highly emetogenic cancer chemotherapy in adults and children aged 6 months and over.
Prevention of nausea and vomiting associated with moderately emetogenic cancer chemotherapy in adults and children aged 6 months and over.
How does fosaprepitant dimeglumine work?
Fosaprepitant is rapidly converted to aprepitant. Aprepitant blocks neurokinin-1 receptors used by substance P, a signalling chemical involved in vomiting pathways. This complements anti-sickness treatments that work through other pathways.
fosaprepitant dimeglumine preparations and strengths
Solution for infusion
Route: Intravenous
Strengths: 150 mg
How to take fosaprepitant dimeglumine
This product is not swallowed. Hospital staff reconstitute and dilute the powder before giving it through a vein. It must not be given undiluted, as a rapid injection, into muscle or under the skin.
Tell staff about allergies, liver problems, pregnancy, breastfeeding and all prescribed, non-prescribed or herbal products you use.
Report burning, pain, redness or swelling around the cannula promptly.
Food does not affect administration because the treatment is intravenous.
fosaprepitant dimeglumine side effects
Common or expected effects
- Hiccups
- Headache
- Indigestion
- Constipation
- Reduced appetite
- Fatigue
- Raised alanine aminotransferase on a blood test
Get urgent medical advice
- Breathing difficulty, wheezing, facial or throat swelling, widespread hives, faintness or collapse suggesting a severe allergic reaction
- Severe infusion-site pain, swelling, inflammation, blistering or tissue damage
- A spreading rash with blistering, peeling skin or sores affecting the mouth, eyes or genitals
fosaprepitant dimeglumine in pregnancy
There are no clinical data from pregnancies exposed to fosaprepitant or aprepitant. Use during pregnancy is advised only when clearly necessary following specialist assessment. Fosaprepitant can reduce hormonal contraception effectiveness, requiring additional precautions specified by the treating team.
fosaprepitant dimeglumine while breastfeeding
It is unknown whether aprepitant passes into human milk, and breastfeeding is not recommended during fosaprepitant treatment. Discuss feeding options and when breastfeeding may resume with the clinical team.
fosaprepitant dimeglumine interactions
Fosaprepitant affects CYP3A4 and may also influence CYP2C9 substrates. A full interaction check is important before administration.
Pimozide, terfenadine, astemizole or cisapride
Concurrent use is contraindicated because raised concentrations may cause serious or life-threatening reactions.
Dexamethasone
Fosaprepitant increases dexamethasone exposure, so the oncology protocol must account for this interaction.
Warfarin
Anticoagulant effect may change, requiring closer INR monitoring.
Common questions about fosaprepitant dimeglumine
Answers are fully visible for fast scanning and source review.
What is fosaprepitant dimeglumine used for?
It helps prevent nausea and vomiting caused by chemotherapy with a moderate or high likelihood of causing sickness. It is used with other anti-sickness treatments.
Is fosaprepitant dimeglumine chemotherapy?
No. It is supportive anti-sickness treatment given alongside chemotherapy; it does not treat cancer itself.
How is it given?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.