FOSAPREPITANT

Background and Date of Approval

Fosaprepitant is an antiemetic agent that belongs to the class of Neurokinin-1 (NK-1) receptor antagonists. FDA approved it on January 25, 2008, for its medical use.

Uses

Fosaprepitant is an intravenously administered antiemetic drug. Fosaprepitant is indicated in adult and pediatric patients ≥ 6 months of age, in combination with other antiemetic agents, for the prevention of acute and delayed nausea and vomiting associated with initial and repeat courses of highly emetogenic cancer chemotherapy, including high-dose cisplatin. It is also indicated for treating delayed nausea and vomiting with initial and repeat courses of moderately emetogenic cancer chemotherapy. Fosaprepitant for injection is not used to treat nausea and vomiting that you already have.

How is it administered?

The drug should be administered only by physicians experienced with cancer chemotherapy. Your physician will determine the dose and frequency of administration based on the type of cancer and severity of the disease. Generally, the drug is administered in a single-dose regimen of 150 mg for adults. Do not self-administer the medicine.

Side Effects

The common side effects include tiredness, diarrhea, low white blood cell and red blood cell counts, weakness, feeling weak or numb in your arms and legs painful, difficulty or changes in your digestion, urinary tract infection, and pain in your arms and legs. Other serious side effects include infusion reactions. Tell your doctor or nurse immediately if you have hives, rash, itching, flushing or redness of your face or skin, trouble breathing or swallowing, dizziness, a rapid or weak heartbeat, or you feel faint during or soon after you receive fosaprepitant.

Warnings

The drug is intended to cause serious drug interactions. You must inform your doctor about the prescribed, over-the-counter medications, vitamin supplements, and herbal medicines you take. With the use of fosaprepitant, severe hypersensitivity reactions like flushing, skin redness, dizziness, low blood pressure, and shock have been reported. Notify your healthcare professional if you face any symptoms during or after the administration of the drug.

Precautions

Inform your physician if you have heart disease, gastrointestinal disease, kidney disease, liver disease, lung disease, blood/bleeding problems, or infection. Inform your physician if you are allergic to the medicine or its ingredients. If you are planning for any surgery, including dental procedures, inform your doctor that you are taking fosaprepitant. This drug may decrease the effectiveness of birth control hormonal pills. If you are pregnant, breastfeeding, or planning for pregnancy, it is advisable to discuss it with your physician. Your healthcare professional may advise you to take certain blood tests to monitor the effectiveness and side effects of the therapy.

Word of Advice

Store the unopened vials at 2°C to 8°C (36°F to 46°F). Do not freeze. Inform your physician if you have liver problems.

References

HIGHLIGHTS of PRESCRIBING INFORMATION These Highlights Do Not Include All the Information Needed to Use EMEND for INJECTION Safely and Effectively. See Full Prescribing Information for EMEND for INJECTION . Accessed on 22 December 2022 https://www.accessdata.fda.gov/drugsatfda_docs/label/2018/022023s017lbl.pdf Fosaprepitant Uses, Side Effects & Warnings. Drugs.com. Accessed December 24, 2022. https://www.drugs.com/mtm/fosaprepitant.html Mary Julia Mycek, Harvey RA, Champe PC. Lippincott’s Illustrated Reviews: Pharmacology . 6th ed. Lippincott-Raven; 2000:408-410. Accessed December 24, 2022. https://lww.com/pages/default.aspx Fosaprepitant. go.drugbank.com. (Updated on December 22, 2022). Accessed December 24, 2022. https://go.drugbank.com/drugs/DB06717

Frequently Asked Questions

Can I become pregnant while taking a fosaprepitant?

It is not known whether fosaprepitant can be administered during pregnancy. It is advisable to consult a physician before getting pregnant if you are taking fosaprepitant.

Who should not receive Fosaprepitant for Injection?

Do not receive the injection if you are allergic to fosaprepitant, aprepitant, or any of its ingredients.

What should I inform the doctor before taking the fosaprepitant?

Inform your doctor if you have liver or kidney problems and other medications that you take.

What is the difference between fosaprepitant and aprepitant?

Fosaprepitant is a prodrug of aprepitant that is converted to aprepitant within 30 minutes when administered intravenously.

How does fosaprepitant work?

Fosaprepitant is an antiemetic. It helps to prevent nausea and vomiting by blocking a chemical in the brain called substance P, which controls your vomiting reflex.

Will fosaprepitant interact with any of my other medications?

Fosaprepitant can interact with many medications, such as pimozide, warfarin, and certain birth control medications.

Written By: P. Thirumal Reddy

Reviewed By: Dr. Tejashwin Adiga