Generic Name and Formulations:
Aprepitant 130mg/18mL; emulsion for IV infusion after dilution; contains egg lecithin, ethanol.
Indications for CINVANTI:
In combination with other antiemetic agents to prevent acute and delayed nausea and vomiting associated with initial and repeat courses of moderately to highly emetogenic cancer chemotherapy, including high-dose cisplatin.
Limitations Of use:
Not studied for treating established nausea and vomiting.
Give with dexamethasone and 5-HT3 antagonist (see full labeling). Administer approx. 30mins prior to chemotherapy. Moderately emetogenic: 100mg IV over 30mins on Day 1, then oral aprepitant 80mg on Days 2 and 3. Highly emetogenic: 130mg IV over 30mins on Day 1.
Severe hepatic impairment. Monitor for hypersensitivity reactions; discontinue and treat appropriately if occur; do not reinitiate if symptoms develop with first-time use. Pregnancy: not recommended. Nursing mothers.
Substance P/NK1 receptor antagonist.
See Contraindications. Monitor concomitant CYP3A4 substrates, including chemotherapy agents (eg, ifosfamide, vinblastine, vincristine). Avoid concomitant moderate-to-strong CYP3A4 inhibitors (eg, ketoconazole, itraconazole, nefazodone, troleandomycin, clarithromycin, ritonavir, nelfinavir, diltiazem) or strong CYP3A4 inducers (eg, carbamazepine, phenytoin, rifampin). Potentiates dexamethasone (reduce its oral dose by 50%), methylprednisolone (reduce its IV dose by 25% and its oral dose by 50%), midazolam, alprazolam, triazolam. May antagonize warfarin (closely monitor INR for 2 weeks after starting each cycle), other CYP2C9 substrates, oral contraceptives (use alternative or backup methods during and for 1 month after last dose).
Headache, fatigue, eructation, infusion-site reactions; anaphylaxis.